Case History : 1


A 30-year-old man presented for rapid appearance of wheals mostly in the back for last 8 weeks

The wheals were of disproportionate size and shapes measuring 0.5mm to 3cm in diameter.

They demonstrated a central swelling of variable size and an associated itching or sometimes burning.

A fleeting duration of usually 1-24 h

Severity score for urticaria - 3

Which of the following indications resembles most with the symptoms and images?


Eczema

Measles

impetigo


Right Answer


Physical factors (cold, heat, sweating, exercise, pressure, sunlight, water and vibration), infective, vasculitic, psychological and idiopathic may all trigger urticarial reactions. These factors trigger histamine release from mast cells in the body, which induce interaction of both H1 and H2 histamine receptors. The mainstay of treatment remains H1 antihistaminic drugs like levocetrizine 5 mg which can provide relief from urticaria.

Wrong Answer


Eczema - Atopic dermatitis (eczema) is a scaly, itchy rash that often affects the face, elbows and knees and appears periodically. It does not match with the given patient symptoms

Wrong Answer


Measles - The diagnosis of measles is usually determined from the classic triad of cough, coryza, and conjunctivitis; the pathognomonic Koplik spots; and the characteristic cephalocaudal progression of the morbilliform exanthem. It does not match with the given patient symptoms

Wrong Answer


Impetigo - Impetigo is a bacterial infection that involves the superficial skin. The most common presentation is yellowish crusts on the face, arms, or legs; sometimes large blisters which affect the groin or armpits. The lesions may be painful or itchy. It does not match with the given patient symptoms

Sachdeva S, Gupta V, Amin SS, Tahseen M. Chronic urticaria. Indian journal of dermatology. 2011 Nov;56(6):622.