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Allergic diseases in children: hives or urticaria ALLERGIC DISEASES IN CHILDREN: HIVES OR URTICARIA
Hives or Urticaria
Hives is an illness characterized by itchy wheals on the skin accompanied, at times, by fever and nausea. It may be acute and last a few hours to a few days or chronic and last months or years. Its common causes are foods (fish, chocolate, nuts, cantaloupe, and corn), drugs (penicillin and aspirin), bee and insect bites, worms in the stool, bacteria in decayed teeth or infected gallbladders, and emotion. Its prevention is through avoidance of such sensitizing foods, drugs, infections, or emotional stress. Treatment (in acute hives caused by a food) is a light purge, to be followed by an allergy-free diet for a few days. In any other form of acute hives, adrenalin and antihistamines have to be used. Chronic hives respond to the long-range use of tranquilizers. Steroids in the treatment of hives should be reserved only for refractory cases that have not responded to the above treatments.
Unusual Forms of Hives
Hives may be caused by allergy to a physical agent such as cold, sunlight, or mechanical pressure. This is proven by the fact that many children who suffer from this kind of allergy have a family history of other allergic disorders as well; that generalized hives may occur even after local exposure to a physical agent; that a gradual desensitization against the causative allergens (with repeated exposure to the physical agent) is possible; that anti-allergic drugs (such as antihistamines) provide relief in this type of hives.
Cold may cause hives after cold showers, after touching ice cubes, or after bathing in the ocean. Accidental drownings have been related frequently to severe systemic reactions caused by massive histamine release while a person is swimming. Children with this sensitivity have to be desensitized against cold by plunging their hands into water that is 50°F. (Use a thermometer to check the temperature of the water.) The first week this must be done twice daily for one minute; the second week, twice daily for two minutes; the third week, twice daily for three minutes; the fourth week, twice daily for four minutes; the fifth week, twice daily for five minutes. If by the fifth week of treatment there is no improvement, the period of desensitization has to be increased by one minute each day until the child's hands are submerged ten minutes per bath twice a day. If no relief is forthcoming, treatment has to be discontinued.
Sunlight may bring about urticaria caused by ultraviolet rays. The swelling and redness of this urticaria are present in the exposed skin; that is, on every part of the body except under the bathing suit. Sun-screening oils must be used before exposure, and antihistamines are also helpful if taken beforehand.
Overeating, gluttony, and excitement may cause hives by promoting the absorption of foods which are not properly digested.
Horse serum used in the treatment of tetanus may cause hives one week after the injection.
Inhalants (dust, molds, or pollen) may cause hives, a condition which usually responds to desensitization.
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