Homoeopathy in the management of urticaria
Abstract : Urticaria is common skin disorder presented with intensely pruritis wheals, sometimes with edema of the subcutaneous or interstitial tissue1. The patient quality of life is impaired because of itch, disfigurement and high associated comorbidity and with the help of appropriate homoeopathic medicines on the basis of symptom simlilarity play an important role in the management of urticaria.
Keywords – Homoeopathy, urticaria, homoeopathic medicines
Introduction – Urticaria is common skin disorder and it refers to an area of focal dermal oedema secondary to a transient increase in a capillary permeability. On certain body sites such as the lips or hands, the oedema spreads deeper and its refer to as an angioedema. By definition the swelling lasts than 24 hours 2.
Although the time frames are somewhat arbitrary, it is useful to ask 2
- How long does the individual lesion last?
>24 hours (urticaria vasculitis)
- How long has the condition been present?
< 6 weeks (acute urticaria)
>6 weeks (chronic urticaria)
Acute- Acute urticaria may be associated with angioedema of lips, face, throat and rarely wheezing, abdominal pain, headache and even anaphylaxis 2.
Chronic- Chronic can be very uncomfortable and interfere with sleep and daily activities.For many people, antihistamines and anti-itch medications provide relief 3.
- Autoimmune due to production of antibodies that cross-link the IgE receptors on mast cells.
- Allergens in foods, inhalants and injections
- Contact eg. Animal saliva, latex
- Physical eg heat, cold, pressure, sun, water
- Infection eg Viral hepatitis, infectious mononeuclosis, HIV seroconversion
- Other conditions eg Systemic lupus erythematosus (SLE), pregnancy, intestinal parasites
- Batches of red or skin coloured welts (wheals), which can appear anywhere on the body
- Welts that in size, change shape and appear and fade repeatedly as the reaction run its course.
- Itching which may be severe
- Painful swelling(angioedema) of lips, eyelids and the inside the throat.
- A tendency for sign and symptoms to flare with triggers such as heat, exercise and stress.
- A tendency for sign and symptoms to persist for more than six weeks and to recur frequently and unpredictably, sometimes for months and years.
- Full blood count, including eosinophil count in case of underlying parasites.
- Erythrocyte sedimentation rate (ESR) may be elevated in case of vasculitis.
- Urea and electrolytes, thyroid and liver function tests may reveal an underlying systemic disorder
- Total IgE and specific IgE to possible allergens, eg, shellfish and peanuts
- Antinuclear factor may be positive in chronic urticaria or urticarial vasculitis.
- Skin biopsy helpful if urticarial vasculitis is suspected.
- Appropriate challenge test to confirm physical urticarias.
Non-sedative antihistamines, such as loratadine, fexofenadine or cetirizine, are effective for perhaps one-third of patients with chronic urticaria; one -third show moderate benefit, whilst the remaining third show minimal benefit.
If a patient fails to respond to one of these agents after 2 weeks of therapy, then it may be worth changing to another non-sedative antihistamine and adding in an H2 blocker such as cimetidine or ranitidine.
Other agents have been used, including mast cell stabilisers or protease and leukotriene inhibitors, but efficacy is not clear.
Apis mellifica – Eruptions like nettle rash over the whole body. Urticaria like bee-stings, or stings from other insects, with intolerable itching at night. Body covered with large, elevated, white wheals.4
Arsenicum album- Urticaria, with burning and restlessness
Astacus fluviatilis- Skin symptom most important. Urticaria.Nettle rash over whole body. Itching. Crustalactea, with enlarged lymphatic glands. Erysipelas, and liver affections with nettle rash. Swelling of cervical gland. Jaundice. 5
Bovista lycoperdon Blunt instrument leave deep impression on the skin. Urticaria on excitement, with rheumatic lameness, palpitation and diarrhoea. Itching on getting warm. Urticaria on waking in the morning, worse from bathing.5Urticaria, covering whole body.4 Calcarea carbonica– Nettle rash; better in cold air. 5
Copaiva officinalis- Hives, with fever and constipation. Roseola. Erysipelatous inflammation, especially around abdomen. Circumscribed lenticular patches, with itching; mottled appearance. Chronic Urticaria on children. Bullous eruptions.5 Large red blotches all over the body with constipation. Nettle rash, pale red or bright red, with violent itching.4 Urticaria after eating shell fish.6
Chloralum hydratum Urticaria, worse, spirituous liquors, hot drinks. Red blotches, like measles.5 Urticaria, coming out at night, disappearing by day. Wheals come on suddenly from a chill; so long as she remains in the warmth is not troubled with them.4
Dulcamara Miliary nettle rash with fever. Dryness and heat of the skin4. Urticaria ameliorate. cold , aggravate.sour stomach7. Nettle rash, with much itching; after scratching in burns; increase in warmth, disappears in cold, with gastric fever .8
Elaterium officinarum Smarts, stings and burns. Dropsical. Urticaria from suppressed intermittent. Skin, orange colour5. Urticaria ameliorate. Rubbing7.
Medusa Numbness; burning pricking heat. Vesicular eruption, especially on face, arms, shoulder and breasts. Nettle-rash.5
Natrium muriaticum Urticaria;
itch and burn. Crusty eruptions on bends of limbs, margin of scalp, behind ears. Hives itching after
exertion5. Nettle rash after violent exercise (itching)4. Urticaria about the joints particularly about the ankles.
Suitable to chronic
Pulsatilla Urticaria, after rich food, with diarrhoea, from delayed menses, worse undressing5. Red spots, like morbilli or nettle rash. Frequent redness, even when the parts are cold.
Eruptions from eating pork, itching violently in bed4. Urticaria of gastric or uterine origin6. Tilia europaea Urticaria. Violent itching and burning like fire after scratching. Eruption of small, red itching pimples. Sweat warm and profuse soon after falling asleep.5
Urtica urens- Urticaria, burning heat, with formication; violent itching. Consequences of suppressed nettlerash. Rheumatism alternates with nettle-rash. Burn confined to skin.
Urticaria nodosa. Erythema, with burning and stinging. Burns and scalds. Angioneurotic oedema.5 The welts are smaller.6
Discussion and conclusion:
Urticaria seriously compromises the quality of life of patients due to its debilitating symptoms that can last for years. So with the help of homoeopathic medicines we can stop further progression of the disease. There are specific medicines which are used effectively in the treatment of all the stages of the diseases. Homoeopathic treatment can help improve the general health of a person with urticaria.
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About the authors
- Dr. Prastuti Jaiswal, Assistant Professor, Department of Homoeopathic Materia Medica Dr. MPK Homoeopathic Medical college, hospital and Research Centre, A Constituent of homoeopathy university, Jaipur ( Rajasthan)
- Dr. Saumya Sharma, (PGR) Department of Homoeopathic materia medica,Dr. MPK Homoeopathic Medical college, hospital and Research Centre, A Constituent of homoeopathy university, Jaipur ( Rajasthan)