Derm: Urticaria: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Urticaria (Hives)🎧 A high-yield breakdown of this itchy, wheal-forming skin condition – crucial for exams and everyday clinical practice.🧠 Key Learning Points📌 Definition• Urticaria (hives) is a transient, pruritic skin eruption characterised by raised, red or pale wheals that resolve within 24 hours.• Angioedema may accompany it and involves deeper skin swelling.📌 Causes & Risk Factors• Allergic triggers – food, medications, insect stings• Non-allergic – cold, heat, pressure, sunlight, vibration, stress• Infections (especially viral), autoimmune diseases (e.g. thyroid)• Chronic idiopathic urticaria – no identifiable cause💡 Mnemonic: "PHYSICAL" – Pressure, Heat, Infection, Cold, Idiopathic, Autoimmune, Latex/drugs📌 Pathophysiology• Mast cell degranulation → histamine release• Histamine → vasodilation + increased capillary permeability• Results in fluid leakage → wheals + intense itching• Angioedema = same process, but deeper tissues affected📌 Symptoms• Sudden onset of raised, itchy wheals (pink/red) with pale centres• Lesions last <24 hours and move around• Angioedema: deeper swelling of lips, eyelids, genitals• Chronic urticaria: symptoms ≥6 weeks📌 Differential Diagnosis• Urticarial vasculitis (painful, persistent >24h, bruising)• Dermatitis herpetiformis (coeliac-related itchy blisters)• Eczema (dry, scaly, fixed)• Bullous pemphigoid• Polymorphic eruption of pregnancy• Mastocytosis (urticaria pigmentosa)📌 Diagnosis• Primarily clinical – based on transient wheals + history• Investigations guided by clinical suspicion• Skin prick or IgE tests for suspected allergy• Challenge tests for inducible types (e.g. ice for cold urticaria)• Biopsy only if urticarial vasculitis suspected📌 Management• Identify and avoid triggers (physical, food, drugs, etc.)• First-line: non-sedating H1 antihistamines (e.g. cetirizine, loratadine)• Increase dose up to 4x for chronic urticaria if needed• Short course of oral steroids for acute severe flares• Second-line: montelukast, omalizumab (anti-IgE), or immunosuppressants in refractory cases• Educate on avoidance of exacerbating factors: stress, alcohol, NSAIDs📌 Complications• Angioedema (esp. lips, eyelids, airway)• Anaphylaxis in allergic urticaria – medical emergency• Chronic symptoms → sleep disturbance, anxiety, depression📌 Prognosis• Acute urticaria usually self-limiting (resolves in days)• Chronic urticaria: ~50% resolve within 3–5 years• Persistent symptoms in ~20% after 10 years• Poorer prognosis if associated with angioedema or autoimmune markers (e.g. antithyroid antibodies)📎 More MSRA Resources for Urticaria📝 Revision Notes: https://www.passthemsra.com/topic/urticaria-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/urticaria-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/urticaria-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/urticaria-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialtyRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Urticaria #Dermatology