Three Necessary Conditions for Treating Urticaria: Etiology and Pathogenesis
The causes are complex, including congenital physical factors and acquired malnutrition. Overnutrition, indigestion, improper clothing and external stimuli are all inducing factors of this disease. Most of the patients are congenital allergic constitution, and about 3/4 of them have a history of allergic diseases.
Clinical manifestations of urticaria in children
The incidence of urticaria in most children has certain inducing factors, such as children catching cold after wearing less clothes, catching cold after playing and sweating, or getting sick after being treated with antibiotics, and food causing urticaria in children. In some cities in southern China, some children suffer from urticaria because they are allergic to fungi and molds. We will also hear some parents say that children get urticaria once playing with sand, or children get urticaria once eating seafood. Gao Legao and other foods are common foods that induce children to get urticaria.
The main manifestations of chronic urticaria are wheal and/or vascular edema. The surface of the wind mass is smooth, red or pink, and there may be a bright red blush around it. If it begins to fade from the center, it may be annular, accompanied by severe itching, which can be seen anywhere and lasts within 24 hours. If subcutaneous or submucosal edema is large and accumulates, it can form vascular edema, which lasts longer than wheal, generally does not itch, and does not leave any trace after fading, and its incidence with urticaria is about 50%; Recurrence and remission alternate, especially at night. Physical urticaria accounts for about 65,438+0/3 of CU. Manual scratching and cholinergic urticaria are common, while cold, heat, sunlight or delayed stress urticaria are rare. This disease mostly occurs after physical stimulation, lasting 65,438+0 ~ 2 h, with symptoms appearing almost every day and severe itching. Autoimmune urticaria is often accompanied by other immune diseases, especially in women, with severe itching and extensive rash. It is resistant to traditional antihistamines and effective to immunosuppressants and glucocorticoid.
Wind mass is the main clinical manifestation of urticaria in children, which is caused by mast cells degranulation and release of inflammatory mediators such as histamine. The increase of capillary permeability produces air masses. Vasodilation causes erythema, and inflammatory mediators stimulate receptors to cause itching. According to the classical theory, antigen binds to the specific antibody IgE on the surface receptor of skin mast cells, which stimulates mast cells to release inflammatory mediators such as histamine. At present, the research on the pathogenesis of chronic urticaria is mostly IgE-mediated autoimmune theory. There is sufficient evidence to prove that most children with urticaria have functional anti-IgE receptor antibodies and/or anti-IgE antibodies that can degranulate skin mast cells or basophils, and the total IgE in serum immunology is higher than normal. Or eosinophils or neutrophils are high; Through the examination of skin tissue extracts, Phanuphak et al. found that the histamine level in rash and non-rash areas increased, and histamine releasing factor could activate mast cells and basophils to release histamine. Some of these factors are IgE-dependent and some are independent. From the immunological analysis of these urticaria, it is concluded that the etiological treatment of urticaria in children needs to fundamentally eliminate excessive IgE antibodies in the body, and the histamine release limit of mast cells returns to normal, resulting in the disappearance of wheal.
The new progress in the basic treatment of children's urticaria (xinminkang anti-allergic probiotics+skin moisturizing emollient+skin antibacterial) is the basic treatment for children's urticaria to reduce the use of skin hormones.
In view of the pathogenic factors of children's urticaria: the increase of IgE in allergic constitution-skin damage and infection-skin barrier dysfunction, which are closely related to the occurrence and development of urticaria, anti-allergic probiotics experts summed up three necessary conditions for the treatment of urticaria:
1. Supplementing Xinmin Kang anti-allergic probiotics (not less than 3 months) can reduce serum IgE allergic antibody, build baby's intestinal barrier function and adjust allergic constitution;
Second, anti-inflammatory treatment is very necessary: Dexamethasone Acetate Cream and Baiduobang Ointment are used externally to fight infection in damaged skin; Paired with chlorphenamine maleate tablets; If you don't take a bath, urticaria will get worse when it gets wet. Moreover, the congenital skin barrier function of urticaria baby is not perfect, and the synthesis of sebum layer of skin is damaged. You should take fewer baths and use skin emollients to protect your skin.
Third, a large number of skin moisturizing boxes are used to care for the skin: it can resist dryness and restore the barrier function of the skin. The emollient containing medicinal urea is better, and 10% urea cream is beneficial to enhance the barrier function of patients. Moisturizing emollients can save about 50% skin hormones when treating urticaria. You should use emollients to protect your skin at least twice a day.
1. Early diagnosis, avoid contact with allergens.
2. Intestinal immunity of allergic probiotics in children with urticaria: In the intestinal immune system, there is an "immune tolerance" mechanism, which will inhibit the immune system from secreting immunoglobulin E(IgE) or G(IgG) that can cause allergic reactions to food ingredients. And allergic people, it is precisely because of the "immune tolerance" mechanism problems, so when eating a particular food, the intestinal immune system will secrete too much immunoglobulin E(IgE) to attack food ingredients, so they have allergies.
Among the four allergic diseases, the incidence of urticaria in children is closely related to the mechanism of intestinal immune tolerance dysfunction in children. After a child with allergic constitution is born, there will be different degrees of infantile eczema and physiological diarrhea within one year. In addition, the overuse of antibiotics in children's medical treatment will directly affect the balance of the "immune tolerance" mechanism, and the "immune tolerance" mechanism will have problems first.
Because the symptoms of infant skin urticaria are not directly related to the cause and effect of diseases that lead to excessive IgE secretion due to "immune tolerance" disorder, it is easy to ignore the immune function of IgE in children's intestines, but children's allergic reactions are getting worse and worse, and generally follow this order: atopic dermatitis (eczema, urticaria)-allergic asthma-allergic rhinitis. Although taking anti-allergic drugs or even glucocorticoids can inhibit the release of inflammatory substances in the body, it can quickly relieve allergic symptoms, but it can't regulate the excessive secretion of IgE, so it can only be relieved when symptoms appear, and it can't prevent allergic symptoms, nor can it improve allergic constitution from the mechanism of "immune tolerance".
Parents should do a good job in nursing measures in their daily lives and pay attention to five aspects:
1, don't let children scratch the affected area with their hands, so as not to scratch more and more; You can use cold compress to relieve itching;
2. Pay attention to balanced nutrition, and children should not eat too much high-protein food;
3, pay attention to hygiene, it is very important to prevent mites at home, to avoid children's contact with pollen;
4, pay attention to the weather changes, with the increase or decrease of clothing, children with urticaria should wear loose and breathable clothing to avoid irritating the affected area;
5, ensure adequate sleep and enhance the body's immunity; Xin Min Kang, an antiallergic probiotic for human body, regulates allergic constitution, regulates immunoglobulin balance by stimulating interferon secretion, and makes human immune response recover correctly, which has a remarkable effect on treating urticaria caused by food, pollen and cold and heat stimulation.