皮膚性病學(xué)課件：蕁麻疹（英文版）

urticariaBasicrequirementsTomasterthecausesandclinicalmanifestionsofurticariaToknowwellabouttherapeuticalwaysToknowabouttheetiologyurticariaDefinition

Urticaria

isaverycommondiseaseandisavascularreactionoftheskincharacterizedbytheappearanceofwheals，whiteorredevanescentplaquesgenerallysurroundedbyaredhaloorflareandassociatedwithsevereitching,stinging,orprickingsensations.EtiologyandpathogenesisEtiologyfoodsEtiologymedicinesEtiologyPhysicalfactors

冷、熱

日

光

等

Cold，hot，sunlight，friction，pressure…Etiologybacteria

virus

真菌infectionsEtiologyAnimalsanimal’sfurskinStingingofinsects

EtiologyPlantspollen

EtiologySpiritfactors

diseaseofinternalorgan.pathogenesisAllergyThemastcellisthePrimaryeffectorcellinUrticarialreactions.NoallergyMedicinesSomesimplecompoundToxinsFoodLeadtoreleasingofHistaminefrommastcellMastcellactivation,isacentralpartoftheurticariaoccurs.ClinicalmanifestationsWhealsitchingAccordingtothecourseAcuteurticariaChronicurticariaAcuteurticaria

occursabruptlyCanbecuredinashortperiodAcuteurticariaUnevensurfacewithorangepeelItalwaysoccurs

abruptly,itwillevolveoverdaystoweeks,producingevanescentwhealsthatindividuallyrarelylastmorethan12hours,withcompleteresolutionoftheurticariawithin6

weeksofonset.Allergicshock:BloodpressureofpatientsmayfallAbdomenachePanicky,dysphoria,nauseaandvomitusDyspneaHighfever,shiveringAcuteurticariachronicurticaria

Dailyepisodesofurticariaand/orangioedemalastingmorethan6

weeksisdesignatedchronicurticaria.SpecialsortsofurticariaDermatographismcoldurticaria

CholinergicurticariaCholinergicurticariaDuetomotion,heat,emotionaltension,eatinghotdrinksorethanoltotrunkdeepinducedfactorssuchastemperaturerise,promptedbyacetylcholinemastcellsandhappen.SolarurticariaangioedemaDiagnosisandmisdiagnosisDiagnosisTypicalclinicalmanifestations:wheals,fastappearinganddiminishing,notraceafterdiminishingandspecialtiesateveryphase.Itcanbediagnosedeasily,butcause–diagnosisareverydifficultinmanycases.

Theidentificationofregularurticariaandpapulesurticaria.GastrointestinaltypeurticariaandidentificationandtheacutegastroenteritismisdiagnosisTreatmentTreatmentSystemictreatmentAcuteurticaria

Mainstayoftreatmentofacuteurticariaisadministrationofantihistamines.Chronicurticaria

Lookingfortherealreasonisveryimportant.corticoidmustavoid.Anti-histamineisimportant,andtheuseofblockingagentofH1.2receptorisbetterforcombinedtreatment.

Shock

Immediateinjectionwith0.1%adrenalinat0.5mlbysubcutaneouspartmaysavethelife;inspiringwithoxygen;meanwhileintravenousinjectionwithhydrocortisoneat0.2to0.3gin500mlglucoseisnecessary.

useantihistamine蕁麻疹是由于皮膚、粘膜小血管擴(kuò)張及滲透性增加而出現(xiàn)的一種局限性水腫反應(yīng)病因食物藥物物理因素感染動(dòng)植物因素精神因素內(nèi)臟及全身疾病等等蕁麻疹肥大細(xì)胞活化是蕁麻疹發(fā)生的中心環(huán)節(jié)臨床表現(xiàn)

圓形、橢圓形或

不規(guī)則形的風(fēng)團(tuán)

此起彼伏急性蕁麻疹發(fā)作迅速、消退不留痕跡，持續(xù)時(shí)間小于6周急性蕁麻疹的非皮膚表現(xiàn)

過敏性休克：心慌、煩躁、惡心、嘔吐甚至血壓降低。主要因血管突然擴(kuò)張引起。

胃腸型表現(xiàn)：腹痛、腹瀉，伴有里急后重及粘液稀便，酷似急腹癥。主要因胃腸粘膜水腫引起。

呼吸道表現(xiàn)：出現(xiàn)呼吸困難、甚至窒息。主要因喉頭粘膜水腫引起。慢性蕁麻疹臨床特點(diǎn)

風(fēng)團(tuán)時(shí)多時(shí)少，反復(fù)發(fā)作超過6周

全身癥狀輕

部分患者皮疹發(fā)作的時(shí)間有規(guī)律

病情遷延、病程長

大多數(shù)患者不能找到病因

診斷

皮疹為風(fēng)團(tuán)

發(fā)生及消退迅速

消退后不留痕跡

病因診斷應(yīng)全面綜合分析后再推斷

治療原則

找出病因，排除發(fā)病因素；

病因不明者，可對(duì)癥處理?？菇M胺藥物的規(guī)