There are two kinds: familial and acquired. The former is autosomal dominant inheritance, which can occur after birth or early years and last for life, and may be accompanied by fever, chills, headache, joint pain and so on. When cold happens; Neutrophils increased, and passive transfer test was negative. The latter is more common in young women. After catching a cold, wheal or patchy edema appears in the contact or exposed parts for 30 minutes or several hours. Sometimes eating cold drinks can cause edema in the mouth and throat, and the passive transfer test is positive. This disease is characterized by itchy edema and wind mass in the cold area after contact with cold water or other cold substances, which can disappear in about half an hour to 1 hour. Most of them are exposed parts such as face and hands, and other parts can be involved in severe cases. Mouth, tongue, pharynx and other mucous membranes will also have edema and even abdominal pain when they encounter cold food or cold drink.
The cause of disease
symptom
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1, family inheritance: There may be two causes of cold urticaria. First, the disease has the characteristics of family inheritance, and the parents of patients may have this disease and pass it on to the next generation; 2. Acquired: Acquired cold urticaria can be divided into primary and secondary. Histamine is the most important inflammatory factor, but prostaglandin and kinin are related to the occurrence of this disease. Histamine releasing factor exists in the blood of patients with spontaneous cold urticaria. The wheal or normal skin of patients with this disease can induce wheal after cold stimulation. Secondary cold urticaria is closely related to some diseases, such as cryoglobulinemia, cold fibrinogen, infectious mononucleosis, rubella, HIV, syphilis, connective tissue and bone marrow malignant tumor. It is acquired by the patient and related to the patient's personal physique. For example, suffering from ... See details.
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brief introduction
classify
cause of a disease
clinical picture
Familial cold urticaria
Acquired cold urticaria
therapeutic method
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brief introduction
classify
cause of a disease
clinical picture
Familial cold urticaria
Acquired cold urticaria
therapeutic method
launch
brief introduction
Symptoms of cold urticaria
Basic introduction:
Cold urticaria is the most common urticaria in physical urticaria, which can be seen at any age.
Pathogenic principle:
After skin contact with cold air, cold water, etc. Itchy edema and wheal appear locally within a few minutes, which can last for 30~60 minutes and relieve after heat preservation, which is more common in young women.
classify
Foreword:
Cold urticaria can be divided into two categories: acquired and familial.
Classification:
Acquired cold urticaria can be divided into primary and secondary. In severe cases, besides wheal, there are numbness of lips, numbness of hands, abdominal pain, shortness of breath, palpitation, diarrhea or syncope. Sometimes eating cold food may cause edema in the mouth or throat. Familial cold urticaria often occurs in infancy and can be seen as early as 1 week after birth. The patient developed a rash from half an hour to four hours after catching cold, which did not itch. The rash is erythema and wheal, accompanied by fever, cold, joint pain, headache and other systemic symptoms.
cause of a disease
1, family inheritance:
There may be two reasons for the onset of cold urticaria. First, the disease has the characteristics of family inheritance, and the patient's parents may have the disease and pass it on to the next generation;
2. Acquired:
Acquired cold urticaria can be divided into primary and secondary. Histamine is the most important inflammatory factor, but prostaglandin and kinin are related to the occurrence of this disease. Histamine releasing factor exists in the blood of patients with spontaneous cold urticaria. The wheal or normal skin of patients with this disease can induce wheal after cold stimulation. Secondary cold urticaria is closely related to some diseases, such as cryoglobulinemia, cold fibrinogen, infectious mononucleosis, rubella, HIV, syphilis, connective tissue disease, bone marrow malignant tumor and so on.
It is acquired by the patient and related to the patient's personal physique. For example, patients stay up late, fatigue leads to low immunity, or some diseases lead to decreased immunity.
clinical picture
urticaria
clinical picture
Cold urticaria is a kind of urticaria, and its clinical manifestations are mainly itching and wheal in different parts under cold conditions. Skin lesions can be confined to exposed parts or parts that come into contact with cold objects under cold conditions, or they can be systemic, involving oral mucosa, and even manifested as headache, chills, diarrhea and tachycardia. There are many opportunities to contact cold objects in winter, so this disease is easy to occur.
Continuous attack
Cold urticaria will form a continuous history of onset, that is, it will recur in the same season every year. Not only the skin surface will appear rash-like swelling, but also the internal organs will appear rash-like swelling in severe cases, which may even lead to death if not treated in time.
noninfectious
Urticaria is not contagious. Urticaria, commonly known as wheal, is a common skin disease. Temporary inflammatory hyperemia and massive fluid exudation are caused by many factors. Causing local edema damage. Its rapid occurrence and disappearance are itchy. So cold urticaria is not contagious.
Familial cold urticaria
Basic introduction
There is another kind called "familial cold urticaria", which is often inherited by chromosome dominance and has a family history. It begins in infancy and often lasts a lifetime.
Pathological manifestations
Edema or erythema occurs 30 minutes to 4 hours after catching a cold, with burning sensation, accompanied by fever, joint pain and other systemic manifestations. People with allergic constitution have the highest incidence, and the cause of urticaria is complex, and its allergens can come from inside and outside. Both men and women can get sick, and there are more women in general. Cold urticaria is mostly acute and often occurs when the temperature drops suddenly. After contact with cold air, cold water or cold objects, the parts exposed or contacted with cold objects become red and swollen, and then itch. Severe cases may be accompanied by fever, asthma, nausea and other symptoms, and even lead to laryngeal edema and suffocation.
Acquired cold urticaria
Basic introduction
Acquired cold urticaria is autosomal dominant inheritance, and the winner may be autoimmune allergic reaction. Histamine release plays a role in the pathogenesis, which can be seen in cryoglobulinemia.
Pathological manifestations
When ice cubes are placed on the skin of the patient's forearm, a typical wind mass can be generated in this part after two minutes. Often accompanied by headache, severe cases can appear symptoms such as hypotension and syncope. Swimming in cold water or taking a cold shower can cause shock or even death. After contact with cold water or other cold substances, itchy edema and wind mass appear in the cold area, which can disappear from about half an hour to about 1 hour. Most of them are exposed parts such as face and hands, and other parts can be involved in severe cases. Mouth, pharynx, tongue and other mucous membranes will also have edema and even abdominal pain when they encounter cold food or cold drink. [ 1]
therapeutic method
Traditional therapy
urticaria
At present, western medicine has no specific treatment for urticaria, and most of them are oral antihistamines and corticosteroids, such as oral western medicine, oral hormones, lotion for external use, emulsion, mud paste, oil, ointment, emulsion, film coating agent, tincture, plaster and so on. Long-term or high-dose topical use of corticosteroids can lead to addiction and drug dependence. The most common thing is that the condition gets better after taking the medicine. Once the medicine is stopped, the primary disease of the medication site gets worse. When the hormone is used again, the above situation improves or disappears; If the drug is stopped again, the rebound will recur and be more serious than before.
In order to avoid the pain after stopping taking drugs, patients are totally dependent on hormones. The skin will obviously become thinner, the capillaries will dilate, and sometimes purpura will appear, especially on the face, which can cause deep persistent erythema. The longer the hormone is used, the heavier the rebound allergy will be. Can make the skin thinner, fragile, atrophic, telangiectasia, purpura, fungal infection, acne-like dermatitis and so on. Become fragile; Mild hirsutism, hyperhidrosis, subcutaneous hemorrhage and difficulty in wound healing may also occur. Especially for some skin diseases, hormone preparations are not suitable.
Long-term or short-term high-dose injection or oral administration of corticosteroids such as dexamethasone, Kangning Ke Tong and prednisone can also cause obesity, hirsutism, acne, hyperglycemia, hypertension, edema, hypokalemia, menstrual disorder, osteoporosis, aseptic osteonecrosis, gastric and duodenal ulcers and other complications. It can also cause certain damage to the kidney, such as aggravating glomerular disease proteinuria, aggravating glomerulosclerosis, easily causing renal calcification or calculus, inducing or aggravating renal infectious diseases, and causing hypokalemic nephropathy. It can also cause metabolic disorder of a series of substances such as sugar, protein, fat, water and electrolyte, destroy the body's defense system and inhibit immune response.
Western medicine treatment
Finding out the reason is mainly to eliminate the reason. Antibiotics are often used in cases of infection, and don't eat them for the time being if you are allergic to certain foods. Chronic infection is often the cause of chronic urticaria, but it is difficult to determine or find the causes of some patients with urticaria.
1. In vivo antihistamines are important drugs for the treatment of various urticaria patients, which can control the symptoms of most patients. Although antihistamines cannot directly antagonize or neutralize histamine and prevent its release, they can compete with histamine and quickly inhibit the generation of wheal. There are many side effects of antihistamines, so it is best to choose the one with small side effects, especially for workers working at high altitude and drivers, who use it with caution and are prone to accidents due to drowsiness. Long-term use of one antihistamine is prone to drug resistance, and another can be used. Or alternatively or in combination. Children's drug resistance is greater than that of adults, so the relative dosage is also greater.
(1) There are many kinds of antihistamines. Antaile (hydroxyzine) can be selected according to the condition and clinical manifestations, which has good stability and antihistamine effect, and has good curative effect on artificial urticaria, cholinergic urticaria and cold urticaria.
(2) Adrenaline and aminophylline can increase CAMP in mast cells, inhibit histamine release, and quickly promote the wheal or edema of acute urticaria's or giant urticaria to subside, especially aminophylline combined with antihistamine or adrenaline, especially suitable for patients with asthma or abdominal pain.
(3)6- aminoacetic acid can be used for cold urticaria and giant urticaria, and atropine or propafenone and chlorpromazine can be used for cholinergic urticaria.
(4) Calcium can be used to treat chronic urticaria with drugs such as acute urticaria, reserpine and Anluoxue.
(5) Steroid hormones are used for severe acute urticaria's disease and serum urticaria, and small doses can be used for stress urticaria and complement-activated urticaria. Urticaria complicated with anaphylactic shock is more necessary. Some people take injections every 3-4 weeks to treat chronic urticaria.
2. Local application of calamine lotion or zinc oxide lotion can achieve temporary curative effect.
3. Drinking vitamin C regularly is an effective method to cure urticaria, which has been confirmed by practice.
food therapy
1. Take fermented grains 100g and corn stigma 15g. Put the corn stigma into aluminum pot, add appropriate amount of water, and boil for 20 minutes. Remove the corn stigma, add distiller's grains, and boil to serve.
2. Use 30g of black sesame and yellow wine 15-30g. Smash sesame seeds and put them in a cup.
urticaria
Add yellow rice wine, cover and steam in the pot 15 minutes. Take sesame wine 1 time every night before going to bed. Daily 1 dose for 1 week.
3. Take boneless chicken 100g and notoginseng1-1.5g.. Slice Notoginseng Radix, fry in chicken oil or pig, add chicken, mix well, put into a bowl, add appropriate amount of water, steam and stew with slow fire 1 hour, add a little salt to taste, and take 2-3 doses of decoction once a day or every 1-2 days.
4. Use more than ten fragrant trees. Wash and cut roots, cook for 5 minutes, add honey, eat and drink. Continuous use for 3 days, daily 1 dose.
5. Take vinegar 100ml, 60g papaya and 9g ginger. 3 * * * people's tastes are boiled in a casserole, and papaya and ginger are taken out when the vinegar is dry. Take it twice in the morning and evening, daily 1 dose, until it is cured.
6. Use 250g duckweed and 5 cicadas. Decoct with water twice a day (morning and evening 1 time). After taking 3 doses, it will be cured without recurrence.
7. Take a handful of chrysanthemum morifolium, put it in a pot and boil it for about 5- 10 minutes, then drink the juice, and you will be cured without recurrence.
8. Wash the fresh loofah leaves with clear water for later use, and rub them continuously for more than 10 times, and no recurrence will occur after recovery.
Love tip: please consult the local regular Chinese medicine hospital for the above prescriptions, and select the prescriptions according to their own physiological characteristics and different pathological changes.
needle therapy
Modern reports on acupuncture treatment of urticaria appeared in the early 1950s. After about 1958, the data of centralized observation of multiple cases gradually increased. Looking at the relevant literature so far, in terms of methods, body acupuncture was the main method in the early stage, and traditional acupoint selection method was mostly used. In recent years, it has become more and more diversified, except body acupuncture, cupping, pricking blood, acupoint injection, acupoint laser irradiation, acupoint oxygenation and so on. Especially cupping at Shenque, which is simple and convenient, is widely used in clinic. Judging from the curative effect, various acupuncture methods have good curative effects on acute and chronic urticaria, and the reported effective rates vary from place to place, ranging from 75% to 95%. Here, only measures such as coarse needle and scalp needle are introduced.
Large needle eye sewing needle
1. Point selection essentials: Touyang. Matching points: Quchi and Xue Hai.
2. Treat main acupoints with No.26 needle. After selecting the acupoints, let the patient sit up, make a fist with both hands, bend his elbow and lie flat on his arm, droop his shoulders, and keep his head as low as possible, so as to tighten the skin on his back and fully expose the spinous process of the vertebral body. Then, the doctor fixed the skin on the upper edge of the spinous process with his left hand, and quickly penetrated the skin with a needle at an angle of 39 degrees with his right hand, and then pressed the needle tightly under the skin, and the needle tip slowly descended under the skin along the midline of the spinous process. Pay attention to the direction of needle insertion parallel to the spinal midline, and avoid skew, and keep the needle 1 hour to 2 hours. Use 28 # millineedle to match points, keep the needle for 30 ~ 60 minutes after getting angry, and apply the method of flat reinforcing and reducing. Every day 1 time, 5 times is a course of treatment, and the interval of treatment is 1 ~ 2 days.
3. Curative effect 52 cases were treated by the above method, 46 cases were cured and 6 cases were effective, with a total effective rate of 65438 000%.
Scalp acupuncture
1. Point selection essentials: oblique line behind the parietal temporal lobe (or 0.5cm away from this line).
2. The treatment of the oblique line behind the top of the temple is equivalent to the line from Baihui to the curved edge. Use a 30 1.5-inch filiform needle to pierce one side of the curved temple from Baihui point, and then pierce the other side of the curved temple, with 4 needles, and pump the needle repeatedly. The method of air extraction is as follows: when the needle tip enters the lower layer of scalp aponeurosis, put the needle flat, slowly insert the needle about 1 inch, then draw it out with explosive force for three times, each time raising 1 minute, and then slowly insert the needle to 1 inch. Keep the needle for more than 2 hours, and it is advisable to keep the needle for many times during this period until the rash is relieved or disappeared. 65438+ 0 times a day, 5 times as a course of treatment, the interval of treatment is 3 ~ 5 days.
3. Criterion of curative effect: Healing: wheal disappears when the needle is inserted and retained, and does not recur after stopping the needle; Effective: the wheal disappeared when the needle was inserted and retained, and the symptoms were obviously alleviated, but it recurred locally after stopping the needle; Ineffective: there was no obvious improvement before and after treatment. 36 cases were cured, 29 cases were cured, 3 cases were effective and 4 cases were ineffective. The total effective rate was 88.9%.
Combined therapy
1. Avoid inducing factors as much as possible, including animal and plant factors, chemical and physical factors. Diet should be light.
2. Encourage drinking more water, and use laxatives and diuretics appropriately when necessary to promote the elimination of allergens.
3. Acupuncture treatment of urticaria with poor effect or severe attack should be combined with traditional Chinese medicine or western medicine.
preventive
abstract
urticaria
Avoid eating foods containing artificial additives and eat more fresh fruits and vegetables. Fried, fried or spicy foods are unlikely to cause thermal reactions in the body. Don't apply hot compress: Some people itch enough to apply hot compress. Although heat can temporarily make local itching less sensitive, it is actually another stimulus, because heat will dilate blood vessels and release more allergens, such as soaking in overheated hot springs or bathtubs, or wrapping in thick quilts to keep warm, which can easily cause urticaria. Eating more fresh fruits and vegetables rich in vitamins or taking vitamins C and B, or B6 in group B, can effectively prevent urticaria. Alkaline foods such as grapes, green tea, kelp, tomatoes, sesame seeds, cucumbers, carrots, bananas, apples, oranges, radishes, mung beans and sweet kernels.
How to prevent winter?
Cold urticaria is a kind of urticaria and belongs to allergic skin disease. With the arrival of cold air in late autumn and cold weather in winter, the number of patients with cold urticaria has gradually increased. The cause of the disease is not completely clear, and some patients are related to heredity. It may be that normal skin protein or denatured skin protein released after skin is stimulated by cold stimulates the human immune system, leading to allergic reaction between them, or that some antibody macromolecules in human blood accumulate after cold. The above reaction causes immune cells to release inflammatory factors such as histamine, so that the small blood vessels of the skin dilate and congestion, the intercellular space of the blood vessel wall increases, and blood components such as plasma proteins ooze from the blood vessels, resulting in local skin blisters or edema. Cold urticaria can be divided into familial and acquired types. The former is a hereditary skin disease, which starts from the baby, and the symptoms decrease with age, often lasting for a lifetime. Acquired cold urticaria can be divided into primary and secondary. The occurrence of primary cold urticaria is related to inflammatory factor histamine. The incidence of secondary cold urticaria is closely related to systemic diseases such as rubella, syphilis, cryoglobulinemia and connective tissue disease. Once suffering from cold urticaria, how to treat it? Antihistamines and leukotriene antagonists or their combination are commonly used in western medicine. Traditional Chinese medicine believes that the disease is caused by exogenous wind-cold and imbalance, so strengthening the body resistance and dispelling cold and harmonizing the camp and the defense are its basic treatment methods. Low dose glucocorticoid is effective for some patients. Antibiotics such as penicillin or tetracycline can completely relieve some patients or improve symptoms. For patients with poor effect of routine treatment, cold tolerance treatment can be considered. The treatment of primary cold urticaria is difficult, and the treatment of secondary cold urticaria needs to treat its primary disease. If the primary disease improves, urticaria will also improve.
How to effectively prevent
Keep warm. Wear hats and gloves on exposed parts of the body, such as face, neck and hands, in winter and when the cold wind blows. Other parts of the body should also pay attention to keep warm and avoid direct stimulation such as cold air and cold water. Like the patient mentioned above, he can't take a cold bath. Adjust your eating habits. Try to avoid eating fish, shrimp, crab, mutton and other high-protein and spicy, alcohol and other irritating foods in winter. Enhance physical fitness. Strengthen physical exercise to adapt to the changes of cold and heat. Drugs. Patients who have to go out in winter and can't completely avoid cold air stimulation need oral antihistamines to relieve their attacks. Through the above measures, it is believed that the symptoms of patients with cold urticaria will be alleviated, or they will not attack, and they can spend the cold winter happily.
The key to prevention
To deal with this cold urticaria, the first thing is to keep warm. Wear hats and gloves on exposed parts of the body, such as face, neck and hands, in winter and when the cold wind blows. Other parts of the body should also be kept warm to avoid direct stimulation such as cold air and cold water. When washing clothes, you can add some hot water to the cold water. In any case, you should try to keep your skin from catching cold and keep it moist. Be sure to use hand cream. In addition, to resist itching after urticaria, don't scratch the skin, which can reduce the irritation to the skin. When itching is unbearable, you can use topical drugs such as Piyanping and Fusong, or see a doctor in time.
First of all, we should get into the habit of listening to and watching the weather forecast. When there is cold air, especially "cold wave", we should pay attention to keep warm and try to avoid going out and suddenly touching cold water.
Secondly, don't use strong alkaline soap for bathing in winter, and don't use other shower gels too frequently to avoid excessive sebum loss. In addition, we should take an active part in physical exercise to improve our body's adaptability to weather changes. For patients with cold urticaria, "desensitization therapy" can be used during the onset period, that is, washing your face with warm water is gradually changed to cold water, and after a period of adaptation, you can contact cold water or cold air to avoid allergic reactions. This method is simple and effective for most patients, but the water temperature should not be too low to feel cold, otherwise it may be counterproductive.
Finally, once suffering from this disease, patients should not grab the affected area, burn with hot water and avoid eating animal protein food and spicy food except for timely treatment in regular hospitals. If the condition is serious, you can take oral antiallergic drugs under the guidance of a doctor. For familial cold urticaria, there is no effective cure except symptomatic treatment at the onset.