urticaria-荨麻疹.pptx

XIAOYANG FENGURTICARIA1.HISTORYbetween 1000-200 years BC.urticaria is called Feng Yin Zheng in The Yellow Emperors Inner ClassicHippokrates(460-377 BC)described itching lesions caused by nettles and mosquitoes which he called knidosis after the Greek word for nettle(knido).The word urticaria was first introduced in 1769 by William Cullen2.WHAT IS URTICARIA(HIVES)?Red or paleitchy wheals On skinDisappear With nothing left in few hours3.CLASSIFICATION AU(acute urticaria)(6 wk)Physical urticaria4.EPIDEMIOLOGY15%to 25%of individuals will experience at least 1 episode of urticaria acute cases(70%)are more common than chronic(30%)Acute urticaria is more common in children and adolescents than in adults,while chronic urticaria more typically affects adults.In chronic urticaria,women are affected more often than men(60%versus 40%of cases,respectively).5.DIAGNOSISWheals appear,and then disappear with nothing left in a few hours.sometimes accompanied by angioedema,or swelling deeper in the skin.The real factor is hard to figure out6.PROVOKING FACTORSfood item:spicy food,egg,fish,strawberry even milk and it product.food additives:as benzoate compound Azodyes.Drug:aspirin,certain antibiotics,NSAID.,codeine,morphine inhalants:-pollen-spore house dust mite.infection and infestation:psychological factor play important role certain systemic diseases:CTD esp.SLE,malignancy lymphoma endocrine diseases as thyrotoxicosis.polycythemia,liver disease,pregnancy 7.CLINICAL SIGNS AU(acute urticaria)CU(chronic urticaria)8.PHYSICAL URTICARIA 1.cholinergic urticaria2.dermographism 9.3.cold urticaria 4.heat urticaria 10.PATHOGENESIShistamine release from mast cells Increased capillary permeability,which allows proteins and fluids to extravasate.The process can be immune mediated or nonimmune mediated.11.IMMUNE-MEDIATED MAST CELL ACTIVATION INCLUDESType I hypersensitivity reactions,in which allergen-bound IgE antibodies bind to high-affinity cell surface receptors on mast cells and basophilsAutoimmune disorders,in which antibodies(IgG)to an IgE receptor functionally cross-link IgE receptors and cause mast cell degranulation12.13.NONIMMUNE-MEDIATED MAST CELL ACTIVATION INCLUDESDirect nonallergic activation of mast cells by certain drugsDrug-induced cyclooxygenase inhibition that activates mast cells by poorly understood mechanismsActivation by physical or emotional stimuli;mechanism is poorly understood but possibly involves the release of neuropeptides that interact with mast cells14.15.TREATMENTDrugs:Antihistamines remain the mainstay of treatment.CetirizineSome Trade Names:ZYRTEC 10 mg once/dayFexofenadineSome Trade Names:ALLEGRA 180 mg once/dayDesloratadineSome Trade Names:CLARINEX5 mg once/dayLevocetirizine 5 mg once/dayAvoid provoking factors16.17.CONCLUSIONSMany types of urticariaUsually nonfetal but really annoyingUrticaria can be caused by allergic or nonallergic mechanisms.Should avoid allergen and could use allergy medicines for urticaria18.FUTURE STUDYResearch about the poorly understand part of the urticaria like how the physical factors stimulate this diseaseFine a effective way to test the allergens19.LEARNEDAll about this disease!20.REFERENCES1.Juhlin Lennart.The History of Urticaria and Angioedema ESHDV Special Annual Lecture,Geneva,October 11th,20002.Zuberbier T,Bindslev-Jensen C,Canonica W,Grattan CE,Greaves MW,Henz BM,Kapp A,Kozel MM,Maurer M,Merk HF,Schafer T,Simon D,Vena GA,Wedi B.EAACI/GALEN/EDF guideline:definition,classification and diagnosis of urticaria.Allergy.2006;61:31620.doi:10.1111/j.1398-9995.2005.00964.x.3.Kindt Thomas,Goldsby A.Richard,Osborne A.Barbara.Kuby immunology sixth edition4.Bingham CO.New onset urticaria:Epidemiology,clinical manifestations,and etiologies.U.May 2010.Grattan C,Black AK,“Chapter 19.Urticaria21.THANKSthanks22.