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Abstract: The patient, Ms. Yang, came to our hospital because of the recent recurrent erythema and wind-bursts with itching in many places of her body. The patient was discharged after 8 days of hospitalization and was found to be cured after 1 week of follow-up.
Basic information】Female, 46 years old
Disease Type】Urticaria
Hospital】The First Hospital of China Medical University
Date of consultation】June 2021
Treatment plan】Intravenous injection (vitamin C injection, cimetidine injection) + oral medication (loratadine citrate tablets, chlorpheniramine maleate tablets) + topical medication (glyburide lotion)
Treatment period】Hospitalization for 8 days, review 1 week after discharge
Treatment effect] The symptoms disappeared and the disease was cured.
I. Initial consultation
The patient is female, 46 years old. She said she suddenly had erythema and pneumatophores with itching all over her body 7 days ago, but the symptoms disappeared after a good night’s sleep, so she did not pay attention to them. As a result, the erythema and wind masses appeared repeatedly in the past few days, on the face, arms and legs, and the itching became more and more severe and unbearable, so she came to our hospital for treatment. I found that the patient had more scattered erythematous and windy spots of different sizes on the face, neck, trunk and extremities, and there was obvious congestion and edema. However, the body temperature and blood pressure were normal, and there was no tenderness. The patient was then admitted to the hospital with the self-report of acute urticaria.
II. Treatment process
After communication with the patient, he agreed to be hospitalized for drug treatment. After admission, the patient was treated with anti-allergic drugs loratadine citrate tablets and chlorpheniramine maleate tablets. At the same time, intravenous vitamin C injection was needed to reduce vascular permeability, and cimetidine injection was injected as an adjunct to the anti-allergic drugs, which was helpful to reduce the allergic reaction. As the patient complained of severe itching, he was instructed to apply topical glyburide lotion to the itchy area to help reduce the itching. After 8 days of hospitalization, the patient’s condition basically improved and requested to be discharged. I agreed to her request for discharge after examination and instructed her to come to the hospital for review in 1 week.
III. Treatment effect
According to the patient’s self-report, she felt that her itchy symptoms were reduced after 1 day of hospitalization. After 8 days of hospitalization, the patient reported that the itchiness disappeared, and I found that the erythema and wind masses on the patient’s face, neck, trunk and limbs had basically disappeared, and no new wind masses had appeared, and the congestion and edema had subsided, and the patient’s body temperature and blood pressure were normal, indicating that her condition had recovered well, so she was discharged. 1 week later, the patient came for a follow-up examination and reported that there was no recurrence, and the erythema and wind masses had completely disappeared. The patient reported no recurrence, the erythema and wind masses completely disappeared, and the physical examination was as the patient said, indicating that the condition had completely recovered.
IV. Notes
The patient’s pruritus disappeared, and the erythema and wind masses in many places of the body were only scattered and small, so he could be discharged from the hospital. However, while I am happy, I also need to tell the patient to pay attention to the following situations after discharge.
1, patients need to pay attention to stay away from allergens, such as seafood, pollen, etc., to avoid triggering the disease or aggravating the disease after going home.
2, the patient is now sensitive and fragile skin, after returning home in the cleaning of their own need to pay attention to avoid the use of hot or cold water, the best use of warm water, the clothing also pay attention to soft and loose, not easy to produce stimulation of the skin.
3. In daily life, we need to observe our own situation, monitor changes in the disease, and seek medical attention in time if there is a recurrence.
V. Personal insight
Urticaria is usually caused by contact with allergens, and it may heal on its own in mild cases, but it is difficult to heal on its own in some patients, and it is easy to recur, as in the case of the patient in this case, which requires timely medical treatment. If the symptoms of acute urticaria are left untreated, they may develop into chronic urticaria, which can last for years and have a significant impact on the patient’s body and daily life, and in severe cases can lead to anaphylaxis, which can be life-threatening. Therefore, it is recommended that we actively treat acute urticaria and try to avoid contact with allergens in our daily lives to reduce the incidence of urticaria.