Hives and Rashes

Side effects of many conditions are rashes and hives after a type I hypersensitivity, immediate hypersensitivity, in which when you are exposed to an allergen. Hives are also known as urticaria which causes itchy welts ranging from small to large spots after exposure to:

  • Foods
    • Shellfish
    • Fish
    • Peanuts
    • Tree nuts
    • Eggs
    • Milk
  • Medications
    • Penicillin
    • Aspirin
    • Ibuprofen
    • Naproxen
    • BP medications
  • Common allergens
    • Pollen
    • Animal dander
    • Latex
    • Insect stings
  • Environmental factors
    • Heat
    • Cold
    • Sunlight
    • Water
    • Pressure on skin
    • Emotional stress
    • Exercise
  • An underlying medical condition
    • HIV
    • CMV
    • Hepatitis
    • EBV
  • Genetics.

Most hives go away within a day, but chronic hives last months to years. However, if treatment is needed, some medication includes:

  • Antihistamines to reduce itching, swelling, allergy
  • Corticosteroids to reduce swelling, redness, itching
  • Autoimmune drugs when other drugs do not work
  • Blood protein controllers if need be.

If you are residing in Denver and have questions or concerns, visit the Denver Holistic Center. Parents and guardians should also be informed of certain lifestyle as well as home remedies:

  • Avoid triggers – foods, medications, pollen, pet dander, latex, insect stings
  • Use over-the-counter antihistamines
    • Claritin
    • Zyrtec
    • Benadryl
  • Apply cool, wet compresses
    • Cover affected area with bandages and dressing to relieve skin scaling from scratching
  • Cool bath
    • Relieve itching
    • Baking soda
    • Aveeno
  • Wear loose and smooth textured cotton clothing
    • Avoid clothes that irritate the child and induce hives or rashes
  • Parents and guardians should keep a regular journal or their child’s condition.

Type I hypersensitivity involves immunoglobulin E (IgE)-mediated release of histamine and other mediators from the mast cells and basophils. When a child first experiences a rash and blood tests are done, physicians will look for IgE levels, basophils, mast cells, histamine, and eosinophil count. Once a cause is identified by the physician, it should be treated and managed to avoid long-term complications that may arise.

 

Figure 1 – Pathogenesis of Type 1 Hypersensitivity: Immunological response → rashes and hives.

Figure 1 – Pathogenesis of Type 1 Hypersensitivity: Immunological response → rashes and hives.

Figure 2 – Type 4 Hypersensitivity: Chronic, Delayed Type Hypersensitivy.

Figure 2 – Type 4 Hypersensitivity: Chronic, Delayed Type Hypersensitivy.

Diseases which may lead to hives and rashes include graft versus host disease (GVHD), Crohn’s disease, and celiac disease. Certain rashes include:

  • Erythema marginatum – associated with Rheumatic fever
  • Erythema chronicum migrans – target lesions associated with Lyme disease
  • Measles – morbiliform
  • Roseola – Human Herpes Virus 6
  • Erythema multiforme – related to allergens and viruses
    • Mild – drugs
    • Moderate – Stevens Johnson Syndrome
    • Severe – Toxic Epidermal Necrolysis
  • Seborrheic dermatitis
  • Seborrheic keratosis – stuck on warts
  • Psoriasis – silvery white plaques
  • Varicella zoster virus – chickenpox
  • Dermatitis herpetiformis – associated with celiac disease
  • Typhoid fever – Salmonella typhi
  • Erysipelas – Pyogenes
  • Jock itch –Tinea cruris
  • Pityriasis rosea – HHV 7
  • Scabies – very itchy.

A child should be tested for these forms of rashes, and then the underlying cause must also be treated and/or managed. Furthermore, there are some skin conditions that are more than just hives or a rash and may indicate a worse prognosis for a child. Conclusively, no diagnosis should be made without ruling out worst case scenario.