Urticaria, and the incidence of vascular edema and Classification

According to the pathogenesis of different can be urticaria - vascular edema into IgE-mediated, complement-mediated, autoimmune and non-idiopathic four major categories (Table 21-1); related pathogenic factors listed in the table . To sum up:
Table 21-1 urticaria - the classification of vascular edema
IgE-mediated A physical allergy The specific antigen B allergies (pollen, Food, drugs, mold, bee venom, worms, etc.) C physical factors, cold, light, vibration, exercise Complement Mediated A hereditary vascular edema: type 1 and type 2 B acquired vascular edema: type 1 and type 2 C necrotizing vasculitis Ding serum disease E reaction to the blood products Non-immune A directly to the mast cells to release medium; opiate, antibiotics, curare, the X-ray contrast agent Other B: aspirin and non-steroid anti-inflammatory agents, such as benzene compounds change the metabolism of arachidonic acid formulations, as well as emotional, sports and hot to acetylcholine, histamine release, and so on. Special hairstyle 1. Only IgE-dependent IgA and IgG defects patients mediated by the two kinds of circumstances that occurred this fall in the rate of allergic reaction. 2. Majority of chronic urticaria for the special hairstyle. 3. Not associated with urticaria, C1 esterase inhibitor (C1INH) defective vascular edema may be congenital autosomal dominant inheritance, may also be acquired; are divided into two lack C1INH type 1 and no functional C1INH type 2. Patients C1 esterase activity inhibition out of control, C4, C2, and other elements consume a lot of pyrolysis products and markedly increased, coupled with bradykinin, and other vasoactive peptide, and other vasoactive peptide activator, resulting in vascular edema. With serum disease or idiopathic skin necrosis vasculitis and emerging urticaria and vascular edema, and the immune complexes activate the complement system. 4. Non-immune is the pathogenesis of autoimmune Table 21-1 non-references listed in the category of some material into the body to stimulate the release of histamine and other mast cells, or because of emotional, physical exercise and to factors such as heat and acetylcholine caused by the release of histamine.
【Pathological changes:
Urticaria features for dermal edema, and edema is the vascular dermis and subcutaneous tissue are edema, the collagen bundles of regional involvement widely separated telangiectasia, perivascular can lymphocytes, cells and eosinophils neutrophil cells, composition of pleomorphic infiltration.
【 Clinical manifestations】
Can occur at any age, with young and middle-aged as common. Urticaria manifested as skin suddenly wind corporations, in a few minutes or a few hours later can be dissipated, generally not more than 24 hours, occurred in groups, sometimes several times a day recurring, a bright red and pale yellow, red, vascular exudative lighter, from white to a wider range of capillary leakage have anemia caused by oppression. Wind block size, the larger up to 10 cm in diameter or greater, and sometimes the surface, there may be blisters, the evacuation order, damage to neighboring fused with each other, forming a special circular, annular, and graphics, can be generalized systemic, after dissipated Leave No Trace, a drama itching, burning or stimulate pain. The acute-general a few days to 1 ~ 2 weeks stopped, but also repeated attack, the course Touching 1 ~ February percent and in some years continued to chronic. Vascular edema and subcutaneous tissue than in the center-site or mucosa, a large swelling transient limitations, ill-defined margin, itching, usually involving the eyelids, lips, tongue, genitals, hands and feet, often occur together and urticaria . If involving the upper respiratory tract, throat and may be life-threatening blockage if involved gastrointestinal tract, the possible abdominal pain, and some are still accompanied by nausea, vomiting, resulting unnecessary surgical exploration. Generally in the 2-3 future disappear.