Urticaria vascular edema and Identification

For chronic, relapsing, and subcutaneous tissue deep dermis large localized edema. The etiology and pathogenesis of the same with urticaria, Only plasma from the deep dermis or subcutaneous tissue of the small gap in vascular endothelial cells and seeping into the surrounding tissues and cause osteoporosis. (1) clinical performance than the eyelids, lips, foreskin, acromegaly, scalp, ear, oral mucosa, tongue, pharynx, larynx, and other sites, the sudden appearance of deep limitations edema damages. Often a single hair, and often occurred in the same location repeatedly, sometimes accompanied by consultation with the nettle. Edema the larger, more border not obvious. The tension skin edema, shiny, pale or light red color, soft texture, it is undeniable dent. Do not itch or mild itching. Edema by 1 ~ 2 h or 2 ~ 3 days dissipated, leaving no trace back. If location in the throat, there will be tightness, throat, hoarseness, difficulty in breathing, under normal circumstances no systemic symptoms. (B) the diagnosis and differential diagnosis of deep under the skin of plaque in edema, no fever, no local lymph node swelling, no thermal lesions or local tenderness, a few points can be sudden onset diagnosis, and with erysipelas or Cellulites phase differential. (3) treatment with urticaria, are generally effective on the H1 receptor antagonist. If there are laryngeal edema, general are not very serious, doctors to remove patients fear, and immediately subcutaneous or intramuscular injection 1:1000 epinephrine Agent 0.3 to 0.5 ml until symptoms dissipated, for observation 0.5 ~ 1 hour, and subsequent application of antihistamines, can be discharged. If sometimes ineffective treatment of adrenaline result of suffocation, should immediately tracheotomy.
Second, hereditary vascular edema (hereditary angioedema)
For autosomal dominant genetic disease, because of a lack of C1 esterase blood inhibitor (CTINH) (accounting for 85% of the patients), or does not lack, but the enzyme activity decreased (15%), while there can not be controlled Complement the production, lead to skin, gastrointestinal, genitourinary tract and larynx in vascular edema. The disease often start at an early age, the repeated attacks and continuing life as a minority in the adult onset may have a clear family history. Often minor injuries (such as extraction), temperature sudden changes, infection, emotional volatility after the attack. Emergency seen both emergency requiring immediate first aid.
(A) The clinical manifestations and vascular edema similar, but with the following characteristics.
1. Edema serious skin edema plaque there without pain is characterized by pruritus. Upper respiratory tract often involved in obstruction of the laryngeal edema caused death, accounting for 25 percent. 2. Gastrointestinal involvement there will be the regular abdominal cramps, intestinal obstruction can sometimes are the signs, accompanied by nausea and vomiting.
(2) According to diagnosis and differential diagnosis of childhood morbidity, pain without itching skin tumors often repeated throat edema and sudden death in the family in the history of respiratory obstruction can be diagnosed with low levels of serum CFINH, C4 low as a basis for further diagnosis can be determined after first aid.
(C) Treatment of antihistamines invalid. Acute attack, the immediate importation of fresh frozen blood Anatomy, intravenous injection of diuretics can often save lives. When laryngeal edema attacks have often required immediate tracheotomy. Androgen prevent attacks and reduce the severity of the attack effects. Acetylene male en-isoxazole hydroxybutyrate (Danazol) 200mg / d or pyrazole n-hydroxymethyl-hsiung (stanozolol) 2.5 to 10 mg / d.