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Hives (cont.)

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What are the causes of chronic hives?

Chronic hives (defined as lasting six weeks or more) can last from months to years. The evaluation of this condition is difficult, and allergy testing and other laboratory tests are only occasionally useful in such cases. The accurate evaluation of this condition requires the patient to give his or her physician precise information regarding their complete medical history, personal habits, and oral intake. Occasionally, it may be necessary to limit specific foods or drugs for a time to observe any affect upon the skin condition. Certain systemic disease and infections may occasionally present in the skin as hives. Rarely, common environmental provocations such as sunlight, water, cold, heat, exercise, and pressure seem to induce hives. If an inciting cause can be determined, then specific treatments for that condition ought to be effective, or in the case of food or drug allergy, strict avoidance would be necessary. There are additionally rare forms of chronic urticaria that are produced when the patient makes antibodies against molecules on the surface of their own mast cells. There are tests available to identify this type of hives.

Physical urticaria is a type of chronic urticaria produced by physical stimuli. By far the most common form is dermographism, which literally means "skin writing." This is an exaggerated form of what happens to anyone when their skin is scratched or rubbed: a red welt appears at the line of the scratch. In dermographism, raised, itchy red welts with adjacent flares appear wherever the skin is scratched or where belts and other articles of clothing rub against the skin, causing mast cells to leak histamine.

Another common form of physically induced hives is called cholinergic urticaria. This produces hundreds of small, itchy bumps. These occur within 15 minutes of exercise or physical exertion and are usually gone before a doctor can examine them. This form of hives happens more often in young people.

Medically Reviewed by a Doctor on 7/11/2014

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Source: MedicineNet.com
http://www.medicinenet.com/hives/article.htm

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