5/2/2011

Incidence Urticaria & Angioedema

David Sudarto Oeiria,MD, FAAD, SpKK
Consultant Dermatologic Surgeon

Medical School, Wijaya Kusuma University Surabaya

15-25 % of the population at some point in their lives, 25% of the patient have chronic urticaria Chronic urticaria, more in women ( female to male 4:1 ) Acute urticaria < 6 weeks Chronic Urticaria>6 weeks

Urticaria
Urticaria is composes of wheals (= transient edematous papules and plaques, usually pruritic and due to edema of the papillary plexus ) and flares The wheals are superficial and well defined Transient, 24 hours (a few hours), clear spontaneously, but new lesions may continue to develop

Pathogenesis
The main pathological change is dermal edema due to vascular dilatation Often in response to HISTAMIN released from MAST cells

Angioedema
Angioedema is a larger edematous area that involves deep dermis and subcutaneous tissue( deep plexus ), the lesion is deep and ill defined. Urticaria and angioedema are thus the same edematous process but involving different levels of the cutaneous vascular plexus.

Can be part of the Systemic Anaphylactic Reaction

Urticaria and Angioedema may form part of a systemic anaphylactic reaction

5/2/2011

Chronic Idiopathic Urticaria (CIU)

Treatment
Urticaria : Antihistamine Angioedema : antihistamine, adrenaline, steroid Anaphylaxis : Adrenaline, Steroid.

When no underlying cause is found, Chronic Urticaria is referred to as CIU

Etiology
Immunologic and Nonimmunologic Immunologic : 1.Acute urticaria: mediated by Ig E, related to Atopic back ground, food, drug, contact urticaria 2.Chronic Urticaria: CIU, Autoimmune Urticaria

Physical urticaria
Dermographism Pressure Cholinergic Urticaria Cold urticaria Water induce urticaria Sunlight induce urticaria Heat induce urticaria