A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.
- Discuss the likely cause of the patient’s urticaria.
- Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
- Describe the relationship between the patient’s symptoms and the concept of inflammation.
- What pharmacological and non-pharmacologic treatment options are available?
- Discuss the complications of urticaria.
- What teaching would be appropriate to provide the parent and child about urticaria?
Support your response with at least one current evidence based resource
Solution:
Discuss the likely cause of the patient’s urticaria.
Urticaria is the appearance of red itchy bumps with varied sizes on skin that result from an allergic reaction (Antia, Baquerizo, Korman, Alikhan, & Bernstein, 2018). The bumps repeatedly appear and fade as the reaction takes place. The likely cause of this patient’s urticaria is physical stimuli specifically exercise. Notice that the patient’s symptoms appear 10 minutes into practice whenever he goes out to play soccer. In addition to exercise, the patient is also exposed to pressure and heat/ sun while playing and thus triggering the development of the urticaria. According to Kaplan (2017), physical stimuli such as exercise, cold, heat, pressure, and sun exposure are a major trigger to hives development.
Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
Urticaria occurs following the release of histamine, leukotriene C4, bradykinin, and prostaglandin D2 from the basophils and mast cells into the dermis (Antia et al., 2018). The released substances result in fluid leakage into the dermis, causing urticarial lesions on the skin as seen in the patient (Wedi & Kapp, 2016). The symptom of itchiness occurs due to release of histamine into the dermis.
Describe the relationship between the patient’s symptoms and the concept of inflammation.
The patient’s symptoms that relate to inflammation include the on and off swelling or rather…Please click the Paypal icon below to purchase full solution for only $10