Wednesday, January 20, 2010

Acute Urticaria a.k.a gatal2!

once again i went to the dermatologist for check up. banyak gila tanya kat doctor tu sampai doctor tu bagi buku medical kat kak uda and dia suruh baca kat pejabat dia sebab dia tengah ramai patient. ingat kan pas habis baca dia nak suruh balik je rupanya dia bagi lagi 1 injection. huh! x boleh bla betul! sakit bontot aku! haha.. ;p btw, thank you doctor sebab dah tolong inject kan sampai sakit bontot aku..

below are some informations about the disease i suffer ;

What is acute urticaria?

Urticaria (sometimes called hives) is an itchy rash caused by tiny amounts of fluid that leak from blood vessels just under the skin surface. Urticaria is classed as:

  • Acute urticaria - if it develops suddenly and lasts less than six weeks. Most cases last 24-48 hours. About 1 in 6 people will have at least one bout of urticaria in their life. It can affect anyone at any age. Some people have recurring bouts of acute urticaria.
  • Chronic urticaria - if it persists longer than six weeks. (Chronic means persistent or ongoing.) This is uncommon.

This rest of this leaflet deals only with acute urticaria. There is a separate leaflet for information about chronic urticaria.

What does the rash of acute urticaria look like?

The rash usually appears suddenly and can affect any area of skin. Small raised areas called weals develop on the skin. The weals look like mild blisters and they are itchy. Each weal is white or red and is usually surrounded by a small red area of skin which is called a flare. The 'weal and flare' rash of urticaria looks similar to the rash caused by a nettle sting.

The weals are commonly 1-2 cm across but can vary in size. There may be just a few but sometimes many develop over various parts of the body. Sometimes weals next to each other join together to form larger ones. The weals can be any shape but are often circular. As a weal fades, the surrounding flare remains for a while. This makes the affected area of skin look blotchy and red. The blotches then fade gradually and the skin returns to normal.

Each weal usually lasts less than 24 hours. However, as some fade away, others may appear. It can then seem as if the rash is moving around the body. The rash may appear quite dramatic if many areas of skin are suddenly affected.

Are there any other symptoms?

  • Most people with acute urticaria do not feel 'ill', but the appearance of the rash and the itch can be troublesome.
  • In some cases a condition called angio-oedema develops at the same time as urticaria. In this condition some fluid also leaks into deeper tissues under the skin which causes the tissues to swell.
    • The swelling of angio-oedema can occur anywhere in the body but most commonly affects the eyelids, lips and genitals.
    • Sometimes the tongue and throat are affected and become swollen. The swelling sometimes becomes bad enough to cause difficulty breathing.
    • Symptoms of angio-oedema tend to last longer than urticarial weals. It may take up to three days for the swollen areas to subside and go.
  • A variation called 'vasculitic urticaria' occurs in a small number of cases. In this condition the weals last more than 24 hours, they are often painful, may become dark red, and may leave a red pigmented mark on the skin when the weal goes.

What causes acute urticaria?

A 'trigger' causes cells in the skin to release chemicals such as histamine. The chemicals cause fluid to leak from tiny blood vessels under the skin surface. The fluid pools to form weals. The chemicals also cause the blood vessels to open wide (dilate) which causes the flare around the weals. The trigger is not identified in about half of cases. Some known triggers include:

  • Allergies - for example:
    • Food allergies such as allergies to nuts, strawberries, citrus fruit, egg, food additives, spices, chocolate, or shellfish. Sometimes you can develop an allergy to a food even if you have eaten it without any problem many times before.
    • Allergies to insect bites and stings.
    • Allergies to medicines such as penicillin, aspirin, anti-inflammatory painkillers, etc.
  • A viral infection such as a cold or 'flu can trigger an urticarial rash in some people. (You 'react' to the virus.) A mild viral infection which causes few other symptoms is probably a common trigger of an urticarial rash that develops without an apparent cause.
  • Skin contact with 'sensitizers' causes a local area of urticaria in some people. For example, chemicals, latex, cosmetics, plants, ointments, nettle stings, etc.
  • Physical urticaria. This is when a localised rash appears when the the skin is physically stimulated. The most common is called dermographism when a rash develops over areas of skin which are firmly stroked. Sometimes an urticarial rash is caused by heat, cold, emotion, exercise, or strong sunlight. See separate leaflet called 'Physical Urticarias'.

Is acute urticaria serious?

Usually not. The rash is itchy but normally fades within a day or so and causes no harm. Most people with acute urticaria do not feel too unwell unless they have a cold or 'flu that is triggering the rash. The cause of the rash is not known in more than half of cases and it is commonly a 'one-off' event.

However, urticaria may be more serious in the following situations.

  • Food allergy. If a food allergy is the cause then the rash is likely to return each time you eat the particular food. This is more often a 'nuisance' than serious.
  • Severe allergies. People who have a severe allergic reaction to peanuts, insect stings, etc, often have an urticarial rash as one of the symptoms. This is in addition to other symptoms such as severe angio-oedema, breathing difficulties, collapse, etc. A severe allergic reaction is called anaphylaxis. But note: most people with acute urticaria feel well and do not have anaphylaxis.
  • Chronic urticaria. This means the rash keeps coming and going on most days for six weeks or longer. This is uncommon. See separate leaflet called 'Chronic Urticaria'.

What is the treatment for acute urticaria?

  • Often no treatment is necessary as the rash commonly goes within 24-48 hours.
  • A cool bath or shower may ease the itch.
  • Antihistamine tablets can ease symptoms. Antihistamines block the action of histamine which is involved in causing urticaria. You can get antihistamines on prescription. You can also buy them from pharmacies. There are several brands. The pharmacist will advise.
    • Modern brands usually work well and are unlikely to cause side-effects. They sometimes cause drowsiness - particularly if you drink alcohol.
    • Older brands will often make you drowsy - but this effect may be welcome at bedtime if itch is troublesome.
  • If you can identify a 'trigger' such as a food, then it would be sensible to avoid it in the future.
  • A short course of steroid tablets is sometimes prescribed in severe cases to help reduce swelling in the skin.

Tuesday, January 19, 2010

thank god i'm alive =)

this is the 2nd month i'm living in gatal2 condition. i went to tayseer medical centre that i think it is not suitable to be called medical centre at all. (because it didnt look like a medical centre! haha..) the doctor said i have some kind of allergy to the weather here and clothes i wear everyday. so she gave me anti histamine tablets to eat n cream to sapu to my gatal2. unfortunately my condition became more terrible! the gatal2 makin banyak and getting worse! arghhh memang tension bila kena tergaru garu kat kuliah! mula la terfikir doctor ni bertauliah ke x?! fuhhh x pe la maybe dia salah wat conclusion pasal gatal2 kak uda ni. during histology practical i asked my dukturah about my gatal2. she asked me "which clinic you go?" i said "tayseer! why?" she said "dont you dare to go to tayseer again! that medical centre kill people!" perghh lagi la menguatkan instinct yang doctor tu bukan salah wat conclusion about my gatal2 tp maybe she is not a good doctor. (aku berazam nak jadi doctor yang bagus dan cemerlang. haha!)
kak uda biarkan je gatal2 ni, wat bodo je eventhough the gatal2 were so gatal and pedih! 2 hari bertahan and arghhhh! x leh tahan! this must come to an end! fikir punya fikir, x pe la g jela dermatologist yg kawan2 suggested. they said the clinic was so near to the imarah. so i asked kak mad to accompany me. jalan punya jalan kak mad pun kata " haa ni la clinic nye!" "whatt??! mak oii x de rupa clinic langsung! cam tempat lepak minum kopi pakcik2 kat malaysia pun ada! adoyai rasa cam nak patah balik pun ada!" emm x pe la alang2 dah sampai masuk la gak an.
i went to the doctor's room ngan hati yg nervous! masuk2, whoaaa x boleh bla la doctor tu! tgh tgk bola, ada kotak rokok kat sebelah! rambut mcm einstein.. haha! emm cerita punya cerita ngan doctor tu, suddenly dia kata "ok i'm gonna give 2 injections, ok?" arghhh tidaakkk! tidaakk! satu2 nye benda yg paling ingin dielakkan! tapi malangnya kena jugak! demi nak baik, ambik la jugak injections tu. jerit? emm jerit x jerit sgt la. org luar x dgr pun.. kak mad ngan doctor je yg dgr. ngee~~ half an hour gak r rasa mcm ada needle kat upper part of gluteus maximus a.k.a bontot! haha.. emm, i paid 80 pounds for the 2 injections and 1 ubat. harap2 la gatal2 ni baik cepat2. dah x larat nak tanggung dah. huwaaaaa... =( THE END...

p/s : mak, ayah, abang, akak, kak lang, dey. pray for me yaa.. i wish i can show u all the gatal2 but korang pon paham an.. haha! x pe la, i'll email to mak later. =)