​Dermatology - Angioedema and Urticaria

​Dermatology - Angioedema and Urticaria 
Both urticaria and angioedema are edematous conditions that affect the cutaneous vasculature at the papillary and deep levels. Papillary wheals make up urticaria, while greater edema involving the dermis and subcutaneous tissue is known as angioedema. These could be recurring, chronic, or acute.

The patient may experience paresthesia from carpal tunnel syndrome and neuropathy, as well as signs of hepatic, renal, and GI involvement, fatigue, weakness, anorexia, weight loss, malaise, or dyspnea. Speech, eating, and breathing can all be affected by oral and throat edema. Cold, sun, allergy, immunologic, drug-induced, autoimmune, physically mediated (dermatographism, pressure or vibration generated), and genetic kinds are among the variations.
Damage
Lesions in solar, pressure, vibration, cold urticaria, and angioedema are localized and restricted to the trigger mechanism location. They are typically regional or widespread in nature. Due to confluence and resolution in one place and progression in another, urticaria are finely defined wheals that range in size from less than 1 cm to more than 8 cm, and they can be round, oval, arciform, annular, or serpiginous. The erythematous or white ring is present. Lesions are itchy and fleeting. Angioedema is a skin-colored, momentary swelling caused by subcutaneous edema that can affect the tongue, lips, eyelids, or other parts of the face or limbs.

Clinical diagnosis is made.
Use hydroxyzine, terfenadine, or loratadine, cetirizine, or flufenadine as antihistamines and H1 blockers. The majority of chronic cases are managed with fexofenadine 180 mg/day or loratadine 10–20 mg/day. Recurrences are typically the result of stopping therapy. When anxiety and depression are linked to severe urticaria, doxepin, a tricyclic antidepressant with strong H1 antihistaminic activity, can be helpful.
Use prednisone for acute urticaria associated with edema. If antihistamines have little impact on chronic idiopathic or autoimmune urticaria, switch to cyclosporine and reduce gradually. If glucocorticoids are contraindicated, or if side effects develop, continue using cyclosporine.