Abstract:
Urticaria is the common skin condition related to hives which something triggered from the outside body. It is pruritic, oedematous, erythematous, blanching papules that are round or oval, pale raised centers (wheals) on the skin, which may sometimes be associated with inflammation and allergy. Homoeopathy has a great scope in treating the urticarial rashes.
Keywords:
Urticaria, Nettle rash, Specific allergen, Homoeopathic medicine.
Introduction:
Urticaria is also known as nettle rash or hives. Urticaria is a word derived from Latin word urtica which means “nettle”. “Nettle” is also a Latin verb “Urere” it means “to burn”. Urticaria is defined as transient erythematous papules and plaques occurring in the skin due to plasma leakage. Urticaria occurring on and off for less than 6 week duration is called ACUTE urticaria and more than 6 weeks duration is called CHRONIC urticaria.
Epidemiology:
Patients of all age groups may develop urticaria, nevertheless 20-40 years old patients are the most frequent patients who develop urticaria. Females are more commonly affected by urticaria than males.
The overall female to male ratio is approximately 2 to 1. Although delayed pressure urticaria is the exception and involves males more than females, with a male to female ratio of 2 to 1. There is no racial predilection to urticaria.
Predisposing factor:
- Emotions
- Heat
- Exercise
- Change in temperature
Aetiology:
a.Drugs: Penicillin and Other Antibiotics, Aspirin,
NSAIDs, Codeine, Morphine, Quinine.
b. Food additives: Tartrazine, Hydroxybenzoates,
Sulphites, Salicylates
c. Foods: Milk and Milk Products, Eggs, Nuts,
Chocolates, Tomato, Pork, Yeast, Strawberries,
Shellfish.
d. Inhalants: Grass Pollens, Mould Spores, Animal
Dander, House Dust.
e. Systemic Disorders: SLE, Autoimmune Thyroid
Disorders.
f. Infections
g. Psychogenic
h. Physical: Friction, Pressure, Cold, Vibration, Sweating,
Sun Exposure.
i. Idiopathic: Chronic spontaneous urticaria.
Classification of urticaria:
Physical and cholinergic urticaria:
It is caused by external stimuli.
Dermographism:
It is a type of physical urticarial where stroking the skin elicits the triple response.
Cholinergic urticaria:
It is also called heat urticaria. It is characterized by the presence of wheals when the patient sweats or does exercise. The wheals are very small and sometimes perifollicular.
Cold uriticaria:
The lesions are confined to the sites exposed to cold and occur within minutes after rewarming.
Aquagenic urticaria:
It occurs when the patient comes in contact with water, irrespective of its temperature.
Solar urticaria:
It occurs on exposure to sunlight (290-400nm of the electromagnetic spectrum)
Urticarial vasculitis:
This type of urticaria is a type 3 hypersensitivity reaction occurs in autoimmune disorders. The wheals will persist for more than 24 hours and may be painful.
Contact urticarial:
It may be immune mediated or non immune mediated. Immunologic contact urticaria occurs in individuals sensitized to contact with external allergens like latex rubber gloves. This is also common in atopic children. Non immunological contact urticaria is due to the direct effects of exogenous urticants penetrating into skin or blood vessels eg. Benzoic acid in eye solutions and food. The wheals may occur within 2 hours of the contact.
Pathogenesis:
Urticaria is caused by transient leakage of plasma through small blood vessels, usually as a result of release of histamine through skin mast cells. There are many causes of these including type 1 hypersensitivity reactions. Histamine also cause itch by stimulating nerve receptors. Other mediators causing vasopermeability include kinins in hereditary angioedema, and leukotrienes in pseudoallergic reactions caused by aspirin and NSAIDS.
Clinical Feature:
• Intense Itching: Stinging and Burning Sensations.
• Manifestation of Urticaria:
▪ Transient
▪ Elevated
▪ Erythematous or pale papules
▪ Plaques
▪ Linear streaks
▪ Generally surrounded by a halo or flare
▪ Edematous lesions (Wheals)
• Size: lesions vary in size from few Millimetres to
several Centimetres.
Investigations:
Establishing the cause of urticaria is difficult. In about 70%
of cases, no clear-cut reason can be detected.
The following may be appropriate:
▪ Full blood count.
▪ Erythrocyte sedimentation rate (ESR).
▪ Urea and Electrolytes, Thyroid and LFT, Iron Studies.
▪ Total IgE and Specific IgE to Possible Allergens.
▪ Antinuclear Factor.
Homoeopathic management:
Therapeutics:
Acidum sulph:
it relieves the troublesome itching and gives relief to the patient. When patient cannot tolerate itching. Chronic urticaria.
Antimonium crudum:
Urticaria on account of indigestion. Thickly white coated white tongue is a sure indication for its use.
Apis melfica:
Sudden puffing up of the whole body, swelling like bites of honey bee. Stinging and burning pains.
Arsenicum album:
Unquenchable thirst for small quantities of water. Restlessness. Burning relieved by warmth. Intense itching.
Astacus fluviatillis:
Irritation is more at night, by the warmth of bed. Chronic urticarial, liver diseases are generally present.
Bovista:
Urticaria on excitement by any kind, itching on getting warm. Urticaria on waking in the morning, worse on bathing. Chronic urticaria.
Chloralosum:
If Apis doesn’t work, it has red eruptions like measles with intense itching and sleeplessness. Urticaria comes out during the night and disappear during the day
is a guiding symptom.
Dulcamara:
Rashes all over body are particular to this disease due to chill and wet weather.
Hepar sulphuricum:
Chronic and recurring urticaria.
Hydrastis:
Hives, rashes of various kinds accompanied by constipation.
Natrium muriaticum:
If there is constipation along with this disease and patient is emaciated with an earthy complexion. Urticaria after taking quinine or after suppression of malaria.
Psorinum: Urticaria after exertion.
Pulsatilla nigricans: Dyspeptic urticaria with vomiting and diarrhea.
Rhus tox:
Urticaria with restless and burning. Itching is better by the warmth of the bed. Uncovering aggravates.
Sepia:
Urticaria worse in open air and better in a warm room after taking milk.
Sulphur:
When there is aggravation at night and the rash is becoming chronic, sulphur can be used for an intercurrent remedy.
Thyreoidinum: It is almost specific in the cure of the disease. More the swelling more the area of infection, more indicated is this remedy.
Urticaria urens: Intense and intolerable itching of the skin. Face is swollen with rash irresistible scratching. This can be applied externally also
Uva ursi:Urticaria without itching.
HOMOEOPATHIC MEDICINE FOR SOME SPECIFIC ALLERGENS:
Allergy
to dust, strong perfumes – Histamine
Allergy to Animal Dander – Tuberculinum
Allergy to Asparagus – Carcinosin
Allergy to Bananas – Phosphorus
Allergy to Bees – Apis mel
Allergy to bread, acidic food – Natrum Mur
Allergy to Butter – Sulphur
Allergy to Buckwheat – Pulsatilla
Allergy to Buckwheat- Pulsatilla
Allergy to Carrots – Phosphorus
Allergy to Castor BeanAlumina, Antimonium ars.
Allergy to Cats- Phosphorus, Tuberculinum
Allergy to Celery- Apium grav
Allergy to Chocolate – Sulphur
Allergy to Cod Liver Oil – Pulsatilla
Allergy to Dogs – Phosphorus
Allergy to Dust – Blatta orientalis, pothos
Allergy to Eggs – Ferrum met, Nat mur, Sulphur, Tuberculinum
Allergy to Fats, Animal- Pulsatilla, Sulphur
Allergy to Feathers – Sulphur
Allergy to Fish – Sulphur, Tuberculinum
Allergy to Flour – Aspidosperma
Allergy to Flowers – Sanguinaria
Allergy to Fruit – Arsenicum alb, Pulsatilla
Allergy to Glutamate – Nat mur, Phosphorus
Allergy to Grass, Freshly Cut – Allium cepa, Dulcamara, Pulsatilla, Sabadadilla
Allergy to Grass Pollens – Medorrhinum, Natrum sulph, Phosphorus, Senega
Allergy to Guinea Pig Hair – Kali carb, Lycopdium
Allergy to Hair Dyes – Sulphur, Tuberculinum
Allergy to Hazelnuts – Phosphorus
Allergy to Honey – Nat mur
Allergy to Hornets – Vespa crabro
Allergy to Insect Bites – Carbolic acid
Allergy to Meat – Nat mur, Sulphur, Tuberculinum
Allergy to Metals – Sulphur
Allergy to Milk – Calc carb, Homarus, Nat mur, Sepia, Sulphur, Tuberculinum,
Urtica urens
Allergy to Mosquito – Culex
Allergy to Onion – Nat mur, Thuja
Allergy to Oranges – Pulsatilla
Allergy to Oysters – Lycopodium
Allergy to Pollen – Blatta orientalis, psorinum
Allergy to Pork – Pulsatilla, Sepia
Allergy to Ragweed – Ambrosia
Allergy to Sardines – Sulphur, Tuberculinum
Allergy to Shellfish – Arsenicum alb., Terebinthina, Urtica urens
Allergy to Starch – Nat mur
Allergy to Strawberries – Carcinosin, Fragaria vesca
Allergy to Sugar – Saccharum officinale
Allergy to Tamarind Seed – Blatta orientalis, Carbo veg
Allergy to Wasps – Vespa crabro
Allergy to Weevils – Grindelia, Ipecac
Allergy to Wheat – Nat mur, Psorinum
Allergy to beer; malt liquor – Kali Bich
Allergy to warm boiled milk – Sepia
Allergy to cod liver oil – Hepar Sulph
Allergy to aspirin, bad liquors, salt butter, bad eggs, poultry items – Carbo
Veg
Allergy to antibiotic – Sulphur
Allergy to antibiotic – Sulphur
Allergy to coffee – Nux Vom
Allergy to heat – Apis Mel
Allergy to cold drinks; fruits; rotten foods, iodine – Arsenic Album –
Allergy to dampness – Dulcamara
Allergy to smell of flowers – Ailanthus
Allergy to sugar – Argentum nit
Allergy to rice – Tellurium
Allergy to cabbage – Petrolium
Allergy to cheese – Nitri-spiritus dulcus
Allergy to dust – Justicia adhatoda.
Refrence:
- Das KV Krishna., 2008. Textbook of Medicine. Jaypee Brothers Medical Publisher (P) Ltd.
- Golwalla, A. and Golwalla, S., n.d. Medicine for students: A Reference book for the family physician..
- Boericke, W. and Boericke, O., 2004. Pocket manual of homœpathic materia medica. New Delhi: Indian Books & Periodicals Publishers.
- Schroyens, F., 1993. Synthesis. London: Homeopathic Book Publishers.
- Murphy, R., 2010. Homeopathic medical repertory. New Deli: B. Jain.
About Author:
Dr. Abinaya
Fathermuller homoeopathic medical college and hospital
