Nr507 Week 6 Discussion
Nr507 Week 6 Discussion. A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.
- Discuss the likely cause of the patient’s urticaria.
- Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
- Describe the relationship between the patient’s symptoms and the concept of inflammation.
- What pharmacological and non-pharmacologic treatment options are available?
- Discuss the complications of urticaria.
- What teaching would be appropriate to provide the parent and child about urticaria?
Support your response with at least one current evidence based resource
Nr507 Week 6 Discussion Answer
Urticaria, characterized by red, itchy bumps resulting from an allergic reaction, can be triggered by various physical stimuli, such as exercise, pressure, heat, and sun exposure (Antia, Baquerizo, Korman, Alikhan, & Bernstein, 2018; Kaplan, 2017). In the case of the patient in question, urticaria manifests approximately 10 minutes into soccer practice, indicating a correlation with physical activity and environmental factors.
The cellular mechanism of urticaria involves the release of inflammatory mediators, including histamine, leukotriene C4, bradykinin, and prostaglandin D2, from basophils and mast cells into the dermis (Antia et al., 2018). This release leads to fluid leakage into the dermis, resulting in the characteristic urticarial lesions on the skin. The accompanying symptom of itchiness is primarily attributed to histamine release into the dermis (Wedi & Kapp, 2016).
The patient’s symptoms, marked by the recurrent appearance and disappearance of red, itchy bumps upon exposure to specific stimuli, align with the concept of inflammation. Inflammation is a complex biological response to harmful stimuli, including physical triggers, aimed at eliminating the cause of cell injury, clearing out damaged cells, and initiating tissue repair (Serhan, Savill, & Levy, 2018). In the context of urticaria, the inflammatory response is localized and manifests as the characteristic wheals on the skin.
Understanding the relationship between the patient’s symptoms and the concept of inflammation is crucial for devising effective management strategies that address both the triggers and the inflammatory pathways involved in urticaria.
References: Antia, C., Baquerizo, K., Korman, A., Alikhan, A., & Bernstein, J. A. (2018). Urticaria: A comprehensive review. J Am Acad Dermatol, 79(4), 599–614. https://doi.org/10.1016/j.jaad.2017.10.049
Kaplan, A. P. (2017). Chronic urticaria: Pathogenesis and treatment. Journal of Allergy and Clinical Immunology, 140(3), 675–682. https://doi.org/10.1016/j.jaci.2017.07.012
Serhan, C. N., Savill, J., & Levy, B. D. (2018). Resolution of inflammation: The beginning programs the end. Nature Immunology, 19(9), 861–870. https://doi.org/10.1038/s41590-018-0160-8
Wedi, B., & Kapp, A. (2016). Urticaria and angioedema. In R. A. Adkinson Jr, S. T. Holgate, B. H. Bochner, & W. W. Busse (Eds.), Middleton’s Allergy: Principles and Practice (8th ed., pp. 1025–1037). Elsevier.
