Angioedema
Angioedema is a condition characterized by swelling in the deeper layers of the skin, often triggered by allergic reactions, although other factors can contribute to its occurrence. This swelling primarily affects areas such as the face, lips, eyes, hands, feet, torso, and genitals. Angioedema can manifest in two forms: acute, lasting from a few minutes to days, and chronic, which persists for longer periods. There are four recognized types: allergic angioedema, idiopathic angioedema, drug-induced angioedema, and hereditary angioedema; the latter being a rare genetic condition. Often accompanying angioedema is urticaria, commonly known as hives, which appears as raised, itchy patches on the skin. Diagnosis typically involves a medical examination and may require blood or allergy tests to identify the specific type. Treatment varies based on the underlying cause but commonly includes antihistamines and, in severe cases, corticosteroids or other medications to manage symptoms. It is crucial to seek immediate medical attention if angioedema is accompanied by breathing difficulties, as this may indicate a life-threatening condition known as anaphylaxis.
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Angioedema
Angioedema is the term given to a condition whereby the skin swells, often as a result of an allergic reaction. Other factors may cause angioedema, and treatment may vary as a result. Angioedema occurs commonly; it is not considered to be a rarity and may be experienced during the lifetime of a considerable number of people. The body parts that are most affected by swelling include the face, particularly the eyes and lips; hands; feet; torso; and also the genitals. The swelling is created by a reaction occurring in the deepest layers of the skin. An excess of fluid in these layers creates a buildup and manifests as swelling. Acute angioedema lasts for anything from a few minutes to a few days. Chronic angioedema is longer lasting. An allergist or immunologist may be the recommended medical practitioner to consult when experiencing symptoms related to angioedema.
Background
There are four types of angioedema, which are classified according to the cause. Allergic angioedema manifests as a swelling due to an allergic reaction. A nut or peanut allergy may trigger this reaction and may result in anaphylaxis. When the cause of the angioedema is not known, this is termed idiopathic angioedema. This type of swelling may be the result of an infection that produces the condition. Alternatively, the swelling may be induced by high levels of stress. Drug-induced angioedema is the name given to swelling that occurs as a side effect to a drug or medication. Drugs that most commonly cause such swelling are angiotensin-converting enzyme inhibitors, abbreviated as ACE inhibitors. The fourth type of angioedema is a serious hereditary category termed hereditary angioedema. This is a genetic condition that is passed from parent to child, presenting as a propensity toward angioedema or swelling. Hereditary angioedema is not common. Only one person among approximately 10,000 to 50,000 people worldwide experience this type of angioedema.
Urticaria. Angioedema often comes with urticaria, or hives, the name given to the specific rash appearing on the skin. The rash is seen as a raised red and itchy area on the body. Another name for urticaria or hives is welts or nettle rash. The sensation on the body may be one of burning or pain. Urticaria is often caused by allergies to food substances, drugs, or contact with an allergy-triggering plant or animal. Allergy tests do not always come up positive regarding urticaria. Women appear to be more susceptible than men to angioedema and urticaria. Angioedema and hives may appear concurrently, or as separate conditions. The first is a swelling underneath the skin, whereas the latter appears as a raised area above the skin.
Aside from the external body parts where it is immediately evident that angioedema is occurring, internal sections of the body may also be affected. The inside of the mouth and tongue may swell, as well as the throat. Of particular concern is the swelling caused to the upper airway, making breathing difficult. The feeling may last for only twenty-four hours, without additional effects of skin irritation such as itching.
Overview
Angioedema is also known as angioneurotic edema. In known cases of angioedema brought about by allergies, the body releases histamine and various chemicals into the blood. This is the body's way of immunizing itself against the allergen that has entered. Sometimes no cause is determined, but the swelling effect happens.
Diagnosis. Diagnosis is possible by a medical doctor viewing the swelling of the skin. While the doctor may be able to ascertain that the dermatological reaction is angioedema, in order to determine which type the patient is experiencing, diagnostic blood or allergy tests may be necessary. When there is no evident cause for the angioedema, this is classified as idiopathic angioedema.
Treatment. Medication may or may not be prescribed for angioedema. In many instances, the swelling naturally goes down, and the person experiencing returns to good health within a matter of days. Medication is often suggested as well. An allergic reaction causing angioedema may necessitate taking an antihistamine to minimize the effect. This is the predominant medication suggested for the treatment of angioedema and urticaria. An oral (tablet) steroid may be administered to reduce swelling. This type of treatment is pertinent to idiopathic angioedema as well. Sometimes antihistamines are ineffective in controlling symptoms of angioedema. In these instances, the doctor may prescribe a drug that suppresses or modulates the person's immune system. Doctors may follow up the administration of these medicines by having the patient go for regular blood checks to monitor the condition and accompanying health. When the condition has arisen due to a drug that has been taken, the doctor may prescribe another type of medication that the patient is not allergic to. In the case of hereditary angioedema, the person who has inherited the condition may require regular medication as a preventive, rather than curative, method of treating the incidences of angioedema. Antihistamines do not work when the angioedema is of a hereditary nature. Urticaria, when accompanying angioedema, may disappear after a few days or remain for a prolonged time and cause anything from mild discomfort to a severe and challenging condition. When lasting longer than six weeks, the urticaria is determined as chronic. Urticaria is also treated with antihistamines or corticosteroid medication.
Severe reactions, or presence of severe effects; non-responsiveness to treatment; or it is the first time the person is experiencing angioedema. Of particular note are respiratory difficulties, in which case there should be no delay in seeking help or treatment.
Anaphylaxis and Angioedema. Anaphylaxis occurring with angioedema is potentially dangerous. Anaphylaxis is life-threatening and can be fatal. If someone is suffering from anaphylactic shock, it is essential to call 911 (in the United States, or 101 for MDA in Israel) immediately. Anaphylaxis is a medical emergency and needs to be treated as such. Anaphylaxis symptoms may include abdominal pain, coughing, dizziness, disorientation and incoherent speech, heart palpitations, vomiting, wheezing, and difficulty breathing and swallowing.
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