Chronic recurrent urticaria code icd 10

Causes of hives

Exogenous:

1. Physical: mechanical, temperature, chemical.
2. Food.
3. Plant substances.

Endogenous:

1. Pathological changes in the urinary system, liver, intestines, oral cavity, nasopharynx, genitals, helminthic infestations.
2. Damage to the autonomic nervous system.

Regardless of the cause, different types of urticaria trigger the same mechanism for the development of pathological changes. The main role in the formation of the leading symptom of urticaria - a blister - is played by mast cells, which represent one of the links in cellular immunity. When a foreign agent enters the body, mast cells are activated and release biologically active reagents - mediators - into the blood. The main mediator that dilates capillaries, increases their permeability and provides perivascular edema is histamine. As a result of its action, swelling of the papillary dermis occurs, intercellular fluid accumulates, resulting in the formation of blisters.

Pathogenesis

Sudden exanthema spreads from person to person, most often through airborne droplets or contact. Peak incidence is spring and autumn. Acquired HHV-6 infection occurs mainly in infants 6-18 months of age. Almost all children become infected before the age of three and remain immune for life.

Most significantly, HHV-6 infection acquired in childhood results in a high rate of seropositivity in adults. In the United States and many other countries, almost all adults are seropositive. The underlying mechanisms of HHV-6 transmission are not well understood. HHV-6 persists after primary infection in blood, respiratory secretions, urine and other physiological secretions.

Apparently, the source of infection for infants is adults who are in close contact with them and are carriers of HHV-6; other modes of transmission are also possible. The relative protection of newborns from primary infection as long as maternal antibodies are present indicates that serum antibodies provide protection against HHV-6.

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The primary infection is characterized by viremia, which stimulates the production of neutralizing antibodies, resulting in cessation of viremia. Specific IgM antibodies appear within the first five days from the onset of clinical symptoms; in the next 1-2 months, IgM decreases and is subsequently undetectable. Specific IgM may be present during reactivation of infection and, as many authors indicate, in small quantities in healthy people.

Specific IgG increases during the second and third weeks, with an increase in their avidity thereafter. IgG to HHV-6 persists throughout life, but in lower quantities than in early childhood. Antibody levels may fluctuate after a primary infection, possibly as a result of reactivation of latent virus.

A significant increase in the level of antibodies, according to some scientists, is observed in the case of infection with other viruses with similar DNA, for example, HHV-7 and CMV. The observations of some researchers indicate that in children, within several years after the primary infection, a fourfold increase in the IgG titer to HHV-6 may again occur, sometimes due to acute infection with another agent; the possible reactivation of latent HHV-6 cannot be excluded.

The literature describes that reinfection with another HHV-6 variant or strain is possible. Cellular immunity is important in controlling primary HHV-6 infection and subsequently maintaining latency. Reactivation of HHV-6 in immunologically compromised patients confirms the importance of cellular immunity.

The acute stage of primary infection is associated with increased NK cell activity, possibly through IL-15 and IFN induction. In vitro studies showed a decrease in viral replication under the influence of exogenous IFN. HHV-6 also induces IL-1 and TNF-α, suggesting that HHV-6 may modulate the immune response during primary infection and reactivation by stimulating cytokine production.

After the primary infection, the virus persists in a latent state or as a chronic infection with virus production. The components of the immune response important in the control of chronic infection are unknown. Reactivation of latent virus occurs in immunologically compromised patients but can also occur in immunocompetent individuals for unknown reasons.

HHV-6 DNA is often found after primary infection in peripheral blood mononuclear cells and secretions of healthy individuals, but the major location of latent HHV-6 infection is unknown. Experimental studies conducted by scientists indicate that HHV-6 latently infects monocytes and macrophages of various tissues, as well as bone marrow stem cells, from which it is subsequently reactivated.

Types and types of urticaria

The types and types of urticaria are divided into:

1. According to the course – acute <6 weeks, chronic >6 weeks.

According to the mechanism of the pathological process – immune, non-immune

Immune urticaria:

Allergic

• Autoimmune
• Non-immune urticaria:

Mechanical – dermographic, vibration, urticaria from pressure and physical impact.

1. Temperature – cold, heat.
2. Solar.
3. Contact.
4. Medication.
5. Idiopathic.

Preventive recommendations

Treatment of generalized urticaria is a long and complex process. Therefore, it is important to prevent the disease. Often this form of allergic reaction occurs due to untimely or self-medication. At the first signs of illness, you should immediately visit a doctor. This will prevent systemic manifestations.

If you are predisposed to allergies, you must avoid contact with allergens. For example, if you are intolerant to some foods, carefully study the composition of the dishes offered.

Medicines should be taken only as prescribed by a doctor. It is important to train resistance to all kinds of irritants of the immune system. To do this you need:

Generalized urticaria is a serious disease that is difficult to treat. At the first signs of relapse of the pathology, all necessary measures should be taken to relieve symptoms in order to prevent the inflammatory process from spreading throughout the body. Always have an antihistamine on hand. After each exacerbation, a visit to the doctor is a must to guarantee successful treatment.

Diagnosis of urticaria

Diagnosis of urticaria is based on the study of medical history, examination data, laboratory tests and instrumental studies.

Medical history: presence in the past of episodes of urticaria or other allergic reactions, the presence of a family history of allergic diseases: intolerance to certain types of products, household chemicals, medicines, perfumes.

Physical examination methods:

1. The characteristic element of the rash is a blister with a dense transparent shell.
2. The elements are embossed and rise above the skin.
3. Blisters vary in shape and size.
4. Cyclical appearance of elements.
5. The effect of using antihistamines.
6. Studies carried out on an outpatient basis:
7. General blood and urine analysis.
8. Examination of stool for helminths and protozoa.
9. Determination of Ig E in blood serum by ELISA.

Additional methods:

1. Biochemistry of blood.
2. Microscopy of skin scraping
3. Study of biological materials of the body: feces, duodenal contents, smears from the nasal and oral cavity.
4. EFGDS.
5. Bacteriological culture of bile.
6. Allergy tests during remission.
7. Finding specific immunoglobulins for parasites using ELISA.

How to relieve itching from hives

To relieve itching from urticaria, local remedies are used in the form of ointments or solutions, which temporarily relieve the severity of the symptom. Preparations with a cooling effect: 1% menthol, 0.5-1% citric acid solution.

• Ointments containing antihistamines: Fenistil gel, Elidel.
• In severe cases, ointments with glucocorticoids are prescribed, which have a rapid effect:

  Fluorocort, Elokom

  .

Symptoms of urticaria

Symptoms of urticaria are represented by a monomorphic rash, the element of which is a blister. A distinctive feature of a rash with urticaria is the instant formation and rapid disappearance of the rash within 24 hours.

In many, urticaria is accompanied by angioedema of the subcutaneous tissue, submucous membrane of the gastrointestinal tract, urinary tract, genitals, and respiratory tract. Edema causes a feeling of fullness and pain in the areas of greatest spread. Completely disappears after 3 days. The favorite location of edema is in areas with poorly developed connective tissue: eyelids, lips, ears, hands, feet, genitals.

Symptoms

Generalized urticaria (we posted photos of symptoms in the article) is characterized by vivid symptoms: the sudden appearance of red blisters all over the body, severe skin itching, which intensifies in the evening, swelling of irritated and inflamed skin, burning. Blisters can be of different diameters, which quite often merge into a solid red spot. They have raised edges and are limited by the papillary layer of skin with a raised surface. Externally, the rash resembles nettle burns, but very extensive. They quickly spread throughout the body and form a large, irregularly shaped spot.

A rash rarely appears on the mucous membranes and lips. During the first two days, the rash disappears in some places, but appears in other areas. The hemorrhagic and bullous form of generalized urticaria is much less common. These forms are dangerous and severe. The patient suffers from chills, possibly increased temperature, loss of appetite, malaise, nausea, joint pain, and nosebleeds.

With a sharp drop in pressure, difficulty breathing and hoarseness, acute pain in the abdomen, loss of consciousness, swelling of the mucous membrane of the throat, mouth, and tongue, urgent hospitalization is necessary.

Complications of urticaria

Complications of urticaria are caused by the diffusion of angioedema into the deep layers of the dermis, subcutaneous tissue, mucous membranes of the respiratory tract and digestive system.

Quincke's edema

Swelling of the mucous membranes of the respiratory tract poses a serious danger. Respiratory failure develops quickly: difficulty breathing, cough, cyanosis of the nasolabial triangle. Without immediate medical attention, this condition can be fatal.

Causes of urticaria

The causes of urticaria are allergic and non-allergic in nature. Allergens:

1. Food: nuts, seafood, citrus fruits, fruits, eggs, honey and much more.
2. Plant toxins.
3. Insect poisons.
4. Helminthic infestations.

Non-allergic causes:

1. Infectious diseases.

Physical factors:

1. solar radiation,
2. cooling, heating,
3. mechanical impact
4. Stress.

Acute allergic reactions :: Symptoms, causes, treatment and code according to ICD-10

...children with a local allergic reaction after vaccination

 Title: Acute allergic reactions.

Acute allergic reactions

 Acute allergic reactions.

These are pathological conditions that arise as a result of the body's hypersensitivity to allergens penetrating from outside and are characterized by the sudden development of localized or generalized allergic reactions.

Localized forms include urticaria, angioedema, laryngospasm and bronchospasm, systemic forms include anaphylactic shock and widespread toxic-allergic dermatitis. The manifestations of an acute allergic reaction depend on its form, the state of the body, age and other factors.

Therapeutic measures include elimination of the allergen, restoration of vital functions, administration of antihistamines and glucocorticosteroids.

 Acute allergic reactions are diseases that develop in the presence of increased sensitivity of the immune system to allergens penetrating the body from outside.

Usually, this reveals signs of an immediate allergic reaction with a sudden acute onset, spread of the pathological process to various organs and tissues, and a pronounced disruption of the vital functions of the body. According to statistics, every tenth inhabitant of our planet has ever suffered an acute allergic reaction.

There are mild (localized) manifestations of hypersensitivity in the form of exacerbation of allergic rhinoconjunctivitis and limited urticaria, moderate - with the development of widespread urticaria, Quincke's edema, laryngospasm, bronchospasm and severe - in the form of anaphylactic shock.

Acute allergic reactions The development of acute allergic reactions is usually associated with exposure to foreign substances that enter the body with inhaled air (bacterial, pollen, allergens contained in atmospheric air and house dust), food, medications, due to insect bites, when using latex, applying on the skin and mucous membranes of various inorganic and organic substances. The pathological process is most often characterized by the development of an immediate acute allergic reaction. In this case, IgE-mediated hypersensitivity to the problematic foreign substance is formed, which becomes an antigen. The developing immune reaction occurs in the presence of three types of cells - macrophages, T- and B-lymphocytes. Class E immunoglobulins synthesized by B cells are located on the surface of target cells (mast cells, basophils). Re-entry of the allergen into the body leads to the development of an acute allergic reaction with activation of target cells and the release of a large number of inflammatory mediators (primarily histamine, as well as serotonin, cytokines, etc.). Such an immune reaction is usually observed upon receipt of pollen, food, household allergens, drugs and serums, manifested by symptoms of hay fever, atopic dermatitis and bronchial asthma, and anaphylactic reactions.

 The mechanism of occurrence of acute allergic diseases may be due to the formation of cytotoxic, immunocomplex, cell-mediated immune reactions. As a result of pathochemical and pathophysiological changes that develop after sensitization, typical symptoms of acute allergy appear.

 A mild course of acute allergic reactions is most often manifested by symptoms of allergic rhinitis (difficulty breathing through the nose, rhinorrhea, sneezing attacks) and conjunctivitis (itching and swelling of the eyelids, redness of the eyes, photophobia). This also includes the appearance of signs of urticaria in a limited area of ​​the skin (round blisters, hyperemia, itching). With a moderate course of acute allergic reactions, the damage to the skin becomes more pronounced and is characterized by the development of generalized urticaria involving almost the entire surface of the skin and the appearance of new blisters within a few days. Often, there are signs of angioedema with the occurrence of limited angioedema of the skin, subcutaneous tissue, and mucous membranes. The pathological process is most often localized in the face, affecting the lips and eyelids, sometimes found on the hands, feet and scrotum, and can lead to swelling of the larynx and the mucous membrane of the gastrointestinal tract. An acute allergic reaction with the development of inflammation of the mucous membrane of the larynx and bronchi can cause severe complications, including death from asphyxia.

 Low-grade fever. Cramps.

 Diagnosis of acute allergic reactions involves a thorough analysis of anamnestic data (tolerance to drugs and serums, previous allergic diseases), clinical manifestations of allergies (damage to the skin, upper respiratory tract, signs of suffocation, fainting, the presence of convulsions, cardiac dysfunction). It is necessary to examine an allergist-immunologist and other specialists: a dermatologist, an otorhinolaryngologist, a gastroenterologist, a rheumatologist, etc. General clinical laboratory tests (blood, urine), a biochemical blood test are performed, according to indications - determination of rheumatoid factor and antinuclear antibodies, markers of viral hepatitis, the presence of antibodies to other microorganisms, as well as instrumental diagnostic procedures necessary in this particular case. If possible, skin tests, determination of general and specific immunoglobulins E, as well as other examinations used in allergology may be performed.

 Differential diagnosis of acute allergic reactions requires the exclusion of a wide range of various allergic, infectious and somatic diseases accompanied by skin manifestations, damage to the mucous membranes of internal organs, and impaired respiratory and circulatory function.

 Therapeutic measures for acute allergic reactions should include the rapid elimination of the allergen, antiallergic therapy, restoration of impaired respiratory functions, blood circulation and other body systems. To stop further intake of the substance that caused the development of hypersensitivity, it is necessary to stop the administration of the drug, serum or blood substitute (with intramuscular and intravenous injections, infusions), reduce the absorption of the allergen (applying a tourniquet above the injection site of the drug or insect bite, pricking this area using a solution adrenaline). Antiallergic therapy involves the use of antihistamines and glucocorticosteroid hormones locally, orally or parenterally. Specific dosages of drugs and the method of their administration depend on the localization of the pathological process, the severity of the acute allergic reaction and the patient’s condition. Symptomatic therapy is aimed at correcting impaired body functions and, above all, breathing and blood circulation. So, in case of bronchospasm, bronchodilator and anti-inflammatory drugs (ipratropium bromide, salbutamol, etc.) are administered by inhalation; in case of severe arterial hypotension, vasopressor amines (dopamine, norepinephrine) are prescribed while simultaneously replenishing the volume of circulating blood.

 In severe cases, emergency care is provided in a hospital intensive care unit using special equipment that supports circulatory and respiratory function.

After the acute manifestations of allergic reactions have been relieved, treatment is carried out by an allergist-immunologist using an individually selected drug therapy regimen, following an elimination diet, and, if necessary, performing ASIT.

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Urticaria in children

Urticaria in children occurs unexpectedly with the appearance of painful itching on the skin, then dense tubeless blisters appear against a hyperemic background. In children, the trigger for hives is food allergies: intolerance to milk, eggs, fish, chocolate and others. In older children, urticaria can be caused by a viral infection (herpes, cytomegalovirus, adenovirus),

Rashes are often combined with a deterioration in the child’s condition: the temperature rises to 38-39 degrees, vomiting and diarrhea occur. The rash is present on the body for 2-3 hours, then disappears without a trace.

Urticaria in adults

The peak incidence of urticaria in adults occurs in the age period from 30 to 50 years. In more than half of the cases, the causative factor causing the pathology remains unclear. Acute forms pass quickly, but if a chronic form develops, the disease can last up to 10 years or more.

Pathogenesis

 Sudden exanthema spreads from person to person, most often through airborne droplets or contact. Peak incidence is spring and autumn. Acquired HHV-6 infection occurs mainly in infants 6-18 months of age. Almost all children become infected before the age of three and remain immune for life. Most significantly, HHV-6 infection acquired in childhood results in a high rate of seropositivity in adults. In the United States and many other countries, almost all adults are seropositive. The underlying mechanisms of HHV-6 transmission are not well understood. HHV-6 persists after primary infection in blood, respiratory secretions, urine and other physiological secretions. Apparently, the source of infection for infants is adults who are in close contact with them and are carriers of HHV-6; other modes of transmission are also possible. The relative protection of newborns from primary infection as long as maternal antibodies are present indicates that serum antibodies provide protection against HHV-6. The primary infection is characterized by viremia, which stimulates the production of neutralizing antibodies, resulting in cessation of viremia. Specific IgM antibodies appear within the first five days from the onset of clinical symptoms; in the next 1-2 months, IgM decreases and is subsequently undetectable. Specific IgM may be present during reactivation of infection and, as many authors indicate, in small quantities in healthy people. Specific IgG increases during the second and third weeks, with an increase in their avidity thereafter. IgG to HHV-6 persists throughout life, but in lower quantities than in early childhood. Antibody levels may fluctuate after a primary infection, possibly as a result of reactivation of latent virus. A significant increase in the level of antibodies, according to some scientists, is observed in the case of infection with other viruses with similar DNA, for example, HHV-7 and CMV. The observations of some researchers indicate that in children, within several years after the primary infection, a fourfold increase in the IgG titer to HHV-6 may again occur, sometimes due to acute infection with another agent; the possible reactivation of latent HHV-6 cannot be excluded. The literature describes that reinfection with another HHV-6 variant or strain is possible. Cellular immunity is important in controlling primary HHV-6 infection and subsequently maintaining latency. Reactivation of HHV-6 in immunologically compromised patients confirms the importance of cellular immunity. The acute stage of primary infection is associated with increased NK cell activity, possibly through IL-15 and IFN induction. In vitro studies showed a decrease in viral replication under the influence of exogenous IFN. HHV-6 also induces IL-1 and TNF-α, suggesting that HHV-6 may modulate the immune response during primary infection and reactivation by stimulating cytokine production. After the primary infection, the virus persists in a latent state or as a chronic infection with virus production. The components of the immune response important in the control of chronic infection are unknown. Reactivation of latent virus occurs in immunologically compromised patients but can also occur in immunocompetent individuals for unknown reasons. HHV-6 DNA is often found after primary infection in peripheral blood mononuclear cells and secretions of healthy individuals, but the major location of latent HHV-6 infection is unknown. Experimental studies conducted by scientists indicate that HHV-6 latently infects monocytes and macrophages of various tissues, as well as bone marrow stem cells, from which it is subsequently reactivated.

Cold urticaria

Cold urticaria appears when the skin is exposed to low temperatures. Its occurrence is explained by the production under the influence of cold of special proteins - cryoglobulins, which have the properties of antibodies. In addition to the typical skin pinkish-red itchy blisters, significant swelling of soft tissues and mucous membranes is observed. The rash lasts from 2 hours to a day, then disappears, leaving no pigmentation.

Solar urticaria

Solar urticaria is one of the types of photodermatoses. Appears when the skin is exposed to ultraviolet radiation while in the sun or in a solarium. It most affects women with liver pathology and acute photosensitivity to ultraviolet radiation. There is a profuse rash of oddly shaped pinkish blisters on open areas of the body, which is combined with painful itching. Spending many hours in the scorching sun is fraught with the appearance of symptoms of sunstroke: headache, drop in blood pressure, fainting.

Types of allergic reactions and codes in the ICD 10 classifier

All diseases are categorized into one regulatory document - ICD-10. Various allergic reactions are also listed there. Each disease is assigned its own code.

The international classifier collects all the information and stores it in one place. There is also a BDU - a threat data bank.

The advantage of the classification is that all the data is collected together, you can find out the characteristics of your disease.

Dysbacteriosis (K92.8)

There is a very close connection between the gastrointestinal tract and allergies. If digestion is disrupted, the body is more susceptible to food reactions. This connection also works in the opposite direction. A person diagnosed with sensitization often suffers due to an imbalance of intestinal microflora.

Signs:

1. Bloating.
2. Nausea and vomiting.
3. Diarrhea. Particularly dangerous for young children.
4. Constipation.
5. Headaches, migraines.
6. Stomach ache.
7. Skin rashes. Mainly on the face and back. Skin problems appear that were not observed before - inflamed acne, comedones.
8. Weakness.

Such symptoms also appear in other diseases. Therefore, an accurate diagnosis is needed.

Types of allergic reactions

Unspecified allergy (ICD-10 code – T78). The class means that the disease has been diagnosed, but the allergen that causes it cannot be found. Also, the wording is used at first, while the cause is being determined. All conditions from this group pose a danger to human life.

What pathologies are manifested by allergic reactions in the form of skin itching and rashes?

The main visual sign of the disease that manifests itself in an allergy sufferer is the appearance of a rash. It is usually accompanied by severe itching. In medicine, there are several types of allergic rashes:

1. Blisters. Convex formations on the epidermis. They have a clear outline and are filled with ichor inside. A single appearance or a cluster of blisters is possible.
2. Eczema. The appearance of cracks in the skin and small wounds. As they heal, they form a crust on the skin. Accompanied by severe itching and dryness.
3. Erythema. Formation of redness on the skin.
4. Pimples and nodules. Rash in the form of red dots.

All these symptoms are usually accompanied by unbearable itching, burning, and dry skin.

Signs appear in the following pathologies:

1. Atopic dermatitis. It appears as redness, pimples or blisters. If left untreated or when scratched, the rash covers the entire body.
2. Toxidermy. The initial stage includes the appearance of spots on the skin. If you ignore the symptoms, complications occur. The disease spreads into the respiratory tract, swelling occurs. There is a high risk of angioedema.
3. Eczema. There are three types: seborrheic, true and professional.
4. Contact dermatitis. Occurs from contact with an allergen in the form of blisters, swelling and itching.
5. Neurodermatitis. Skin rashes due to nervous system disorders.
6. Hives. Occurs anywhere in the body suddenly. A cluster of red blisters appears.

Features of acute food allergies, code according to ICD-10

Food allergy (ICD-10 - T78.1) is accompanied by a large number of symptoms, which depend on the amount of allergen ingested. Signs appear on the skin, in the respiratory tract, in the gastrointestinal tract, and in disorders of the nervous system.

Signs can be seen within minutes of contact with the compound. But it may appear later in a few days.

Acute allergic reactions manifest themselves immediately. In this case, the person’s condition immediately worsens.

Anaphylactic shock is possible and requires immediate medical attention.

Most often, this condition appears from sensitization to nuts.

Drug allergic reaction - differences, coding

The code in the International Classification is T78.4. The body's response to medications most often occurs to the following drugs:

1. Antibiotics.
2. Analgesics.
3. Anti-inflammatory drugs.
4. B vitamins.
5. Preparations with iodine.

These are the main aggressors. But an individual reaction can occur to any drug.

The disease can also affect many body systems:

1. The appearance of rashes and redness, itching.
2. Rhinitis and conjunctivitis.
3. Breathing problems.
4. Edema.
5. Abdominal pain, nausea and vomiting.
6. Anaphylactic shock.

Signs appear within a few seconds or after a few days. Often the patient requires urgent hospitalization.

Chronic recurrent urticaria

Chronic recurrent urticaria occurs in a sensitized body, in which sources of chronic infection have been present for a long time: pharyngitis, tonsillitis, cholecystitis, adnexitis and others; functional or organic lesions of the gastrointestinal tract and organs involved in the digestive process (liver, gall bladder, pancreas). The disease occurs cyclically: relapses alternate with periods of relative well-being - remissions. With relapses, signs of intoxication are present: headaches, fever, arthalgia. With massive swelling of the submucous membrane of the gastrointestinal tract - nausea, vomiting, diarrhea. Constant itching leads to insomnia, increased fatigue, and irritability.

Medications

The patient needs to take antihistamines:

1. "Tavegil".
2. "Suprastin".
3. "Zodak".
4. "Loratadine."

First generation antihistamine blockers can be taken only in case of a sharp exacerbation of symptoms. This will quickly relieve symptoms and prevent the development of Quincke's edema. The emergency doctor will prescribe an injection (intravenous) of an antihistamine or (in severe cases) Prednisolone.

If there is a suspicion of the development of Quincke's edema, the patient will be injected with Epinephrine intramuscularly. Blood pressure is restored using saline crystalloid solutions, which are administered intravenously. When the pathology is accompanied by convulsive syndrome, the doctor prescribes the administration of Diazepam or Relanium. Generalized urticaria, in which the patient's general condition quickly deteriorates, requires emergency treatment in the intensive care unit or intensive care unit.

Depending on the allergen that provoked the disease, in addition to antihistamine therapy, the use of diuretics, sorbents, and plasmapheresis sessions may be required. If necessary, drugs that act on the central nervous system can be prescribed. Amitriptyline helps relieve anxiety. To reduce skin irritation and itching, non-steroidal agents are used externally:

1. "Bepanten."
2. "Solcoseryl".
3. "Wundehil."
4. "Desitin."

Do not use hormonal ointments on large areas of the skin.

Treatment of urticaria

Treatment of urticaria is complex and includes non-medicinal methods (diet, lifestyle) and medications. Non-drug therapy:

• If possible, eliminate the causative factor causing urticaria.
• Normalization of the patient’s lifestyle: eliminate overheating, hypothermia, and physical stress.
• Avoiding stress.
• A balanced diet excluding possible allergens (seafood, eggs, honey and others).

Taking medications only with the permission of a doctor.

Antihistamines are the basis of basic therapy for chronic forms of urticaria.

If the process tends to be protracted and treatment is ineffective, systemic glucocorticoids are used.

Preparations for urticaria

Antihistamines II and III generations without a sedative effect: Loratadine, Cetirizine, Zyrtec, Claritin.

Mast cell stabilizer drugs: Ketotifen.

Glucocorticoids: Prednisolone, Dexamethasone, Betamethasone.

Types of pathology

The disease can have two development options: non-immune and immune. The second option is more common. When an allergen enters the body, the immune system begins to intensively produce immunoglobulin E against it. During the interaction of antigens with it, mast cells are destroyed, a large amount of histamine is released into the blood, which increases the permeability of the vascular walls and causes typical symptoms of urticaria.

The nonimmune form of generalized urticaria is associated with exposure of mast cells to an allergen. Scientists today cannot yet name the true causes of the disease. It has been established that the generalized form of urticaria occurs more often in people with a history of atopic diseases of allergic origin.

About 75% of officially recorded cases of the disease represent an acute form of urticaria. Rapid development and a duration of no more than one and a half months are characteristic of it. Its development is often associated with improper use of medications. Quite often diagnosed in children.

Chronic generalized urticaria is diagnosed in 25% of cases. Depending on the clinical picture, it is divided into:

• recurrent;
• persistent (sluggish).

The disease is often diagnosed in childhood, and throughout life it can cause relapses whenever an allergen enters the bloodstream.

Question answer

Is it possible to wash with urticaria
? The disease is not a contraindication for washing the body, but there are some restrictions: It is better to wash in the shower with warm water, avoiding sudden changes in water temperature. Taking a bath is undesirable, since prolonged exposure to water on the skin leads to softening of the upper stratum corneum of the skin and increased swelling. Do not use synthetic hard washcloths, shampoos, or gels when washing. It is allowed to use hypoallergenic detergents or fragrance-free baby soap.

Can I drink if I have hives?

Any type of alcohol with obvious signs of urticaria is strictly contraindicated, as it can cause such a serious complication as Quincke's edema.

Is it possible to swim if you have hives?

Swimming in the pool and open water is not allowed during exacerbations of urticaria. Various reagents are added to the pool to purify the water, which will cause an increase in symptoms.

Is it possible to use suprastin for urticaria?

Suprastin is prescribed for urticaria, as it belongs to the 1st generation antihistamines. Due to side effects, it is contraindicated in pregnancy and breastfeeding women. In addition, it has an inhibitory effect on the central nervous system (impaired coordination of movements, drowsiness), so it is used with caution in people who need a quick reaction: driving a car, working in production.

Is it possible to eat persimmons for urticaria?

No you can not. Persimmon is a highly allergenic product and can itself provoke an allergic reaction.

Is it possible to go to the bathhouse if you have hives?

Sudden changes in temperature negatively affect the skin affected by urticaria. Therefore, visiting baths and saunas is not recommended for this disease.

Is it possible to use pumpkin for hives?

Pumpkin does not have a pronounced allergenicity, but given that with urticaria there is an increased sensitivity to many food components, during an exacerbation it is undesirable to use this vegetable in the patient’s diet.

Allergic reaction code according to ICD 10: classification

Allergies are included in the database of the International Classification of Diseases, a document that serves as the basic statistical and classification basis for healthcare in different countries. The system developed by doctors allows you to convert the verbal formulation of the diagnosis into an alphanumeric code, ensuring ease of storage and use of data.

So an allergic reaction according to the ICD is coded with the number 10 . The code includes one Latin letter and three numbers (from A00.0 to Z99.9), which allows you to encode another 100 three-digit categories in each group. Group U is reserved for special purposes (recording new diseases that cannot be classified into an existing classification system).

Types of allergic reactions and their codes according to ICD-10

In the 10th classification, diseases caused by the response of the immune system are divided into different groups depending on the symptoms and characteristics of the course:

• contact dermatitis (L23);
• urticaria (L50);
• rhinitis (J30);
• dysbacteriosis (K92.8);
• unspecified allergy (T78).

Important! We can talk about the presence of allergies only if test results and other examination methods exclude diseases that provoke the occurrence of similar symptoms.

A correct diagnosis is the key to a successful fight against the disease, because different types of allergies often require different approaches to treatment and adherence to a number of rules to minimize unpleasant manifestations and improve the quality of life.

Allergic contact dermatitis (L23)

Unlike most “classical” allergic reactions, which are triggered by humoral immunity, contact dermatitis is a cellular immune response. From the moment of skin contact with the allergen to obvious skin manifestations, an example of which can be seen in the photo, an average of 14 days passes, since the process is triggered by a delayed-type hypersensitivity mechanism.

Today more than 3000 allergens are known:

• elements of plant origin;
• metals and alloys;
• chemical compounds that make up rubber;
• preservatives and flavoring additives;
• medications;
• other substances found in dyes, cosmetic products, glue, insecticides, etc.

Contact dermatitis is manifested by redness of the skin, local rash, swelling, blistering and intense itching. As can be seen in the photo, skin inflammation is local in nature. The severity of manifestations depends on the duration of contact with the allergen.

There are acute and chronic dermatitis. The acute form is most often observed with a single contact, while the chronic form can develop over time if a person is constantly in contact with an element dangerous to the body. The picture of chronic dermatitis is typical for people whose professional activities involve frequent contact with aggressive compounds.

Allergic urticaria ICD-10 (L 50)

WHO statistics show that 90% of people have encountered this problem at least once in their lives. The photo shows what allergic urticaria ICD 10 looks like, resulting from contact with allergens.

According to the classification, this type of allergy is classified in group L50 “Diseases of the skin and subcutaneous tissue.” The alphanumeric code for urticaria caused by a reaction to an allergen is L50.0.

Most often, hives, caused by the immune system's response to a specific irritant, occur suddenly, causing symptoms such as:

• blisters that can form both on the skin and mucous membranes and reach a diameter of 10-15 cm;
• itching and burning;
• chills or fever;
• abdominal pain and nausea (possible vomiting);
• deterioration of general condition.

Acute urticaria, provided appropriate treatment is prescribed, resolves within 6 weeks (in some cases much faster).

If the symptoms persist longer, the disease becomes chronic, which can significantly worsen the quality of life.

Chronic urticaria is characterized not only by skin problems, but also by sleep disturbances, changes in the emotional background, and the development of a number of psychological problems, which often lead to social isolation of a person.

Allergic rhinitis (J30)

Rhinitis often occurs when the mucous membrane comes into contact with a certain type of allergen. Group J30 lists the following diagnoses:

• J30.2 – Vasomotor rhinitis, which can occur against the background of autonomic neurosis or under the influence of any allergen.
• J30.1 – Hay fever (hay fever). It is caused by pollen present in large quantities in the air during flowering plants.
• J30.2 – Other seasonal rhinitis occurring in pregnant women and people suffering from allergies to tree blossoms in the spring.
• J30.3 – Other allergic rhinitis that occurs as a response to contact with vapors of various chemicals, medications, perfumes or insect bites.
• J30.4 – Allergic rhinitis, unspecified. This code is used if all tests indicate the presence of an allergy manifested as rhinitis, but there is no clear response to the tests.

The disease is accompanied by inflammation of the nasal mucosa, which causes sneezing, runny nose, swelling and difficulty breathing. Over time, these symptoms may be accompanied by a cough, which without treatment can lead to the development of asthma.

General and local drugs help improve the condition, the complex of which is selected by an allergist taking into account the severity of symptoms, the patient’s age and other diseases in the anamnesis.

Dysbacteriosis of allergic nature (K92.8)

Dysbacteriosis is a set of symptoms caused by clinical disorders of the gastrointestinal tract, which occur against the background of changes in the properties and composition of the intestinal microflora or under the influence of substances released during the life of helminths.

Doctors and scientists note that the relationship between allergies and dysbiosis is very strong. Just as disturbances in the gastrointestinal tract provoke the development of a reaction to certain food allergens, an existing allergy in a person can cause an imbalance in the intestinal microflora.

Symptoms of allergic dysbiosis include:

• diarrhea;
• constipation;
• flatulence;
• stomach pain;
• general skin manifestations characteristic of food allergies;
• lack of appetite;
• headache;
• general weakness.

Important! Since such symptoms are characteristic of many ailments, including acute poisoning and infectious diseases, it is important to seek help from specialists as soon as possible to identify the cause that caused the symptoms described above.

Diarrhea is especially dangerous for children, since dehydration in combination with the accumulation of toxic substances can have serious consequences, including death.

Adverse effects not elsewhere classified (T78)

The T78 group included adverse effects that occur when the body is exposed to various allergens. The 10th edition of the ICD classifies:

• 0 – Anaphylactic shock due to food allergies.
• 1 – Other pathological reactions that occur after eating.
• 2 – Anaphylactic shock, unspecified. The diagnosis is made if the allergen that caused such a strong immune response is not identified.
• 3 – Angioedema (Quincke's edema).
• 4 – Unspecified allergy. As a rule, this formulation is used until the necessary tests have been carried out and the allergen has been identified.
• 8 – Other adverse conditions of an allergic nature not classified in the ICD.
• 9 – Unspecified adverse reactions.

The conditions listed in this group are especially dangerous because they can be life-threatening.

Source: https://snall.ru/klassifikaciya-allergicheskih-reakcij-po-mkb-10.html

Classification

As mentioned above, all forms of allergic urticaria are divided into two types - acute and chronic. The boundary between them is quite arbitrary - it is believed that in the acute form, rashes and itching persist for no more than 6 weeks, while if they bother the patient longer, a diagnosis of chronic allergic urticaria is made. In addition, it is important to differentiate true allergic urticaria from pseudoallergy, in which activation of mast cells occurs without the participation of immune mechanisms. There are many varieties of this condition - for example, mechanical types of pseudo-allergies include the following: • Dermographic urticaria (urticarial dermographism) - provoked by simple physical pressure on the skin (seams of clothing, for example).

Non-immune mechanisms of mast cell activation most often play a role in the pathogenesis of this condition.
• Cold urticaria.
This type of temperature urticaria has become increasingly common in recent years.
It was found that in patients with this pathology, during cooling, the level of certain platelet factors increases and the stability of the mast cell membrane decreases. Against the background of increased sensitivity of skin tissue to histamine, this can lead to the development of erythematous rashes and itching, both with local exposure to cold and with the consumption of cold foods and drinks. • Heat urticaria.
It is a rather rare variant of urticaria.
Just as in the case of urticarial dermographism, the main role in the development of this type of disease is played by non-immune mechanisms of activation of mast cells - their degranulation occurs with increasing temperature. • Solar urticaria (photoallergy).
The provoking factor in this case is sunlight.
Patients with this type of urticaria have an increased sensitivity of the skin to histamine, so the degranulation of even a small number of mast cells leads to noticeable disturbances. • Vibratory urticaria.
It is a fairly rare form and often has signs of an occupational disease (in construction workers, in production).
In this case, degranulation of basophils occurs due to mechanical shock of the tissues. • Aquagenic urticaria.
Previously, it was not classified as a mechanical variety of urticaria, but in recent years there have been indications that the provoking factor in this case is the physical impact of jets of water. Activation of skin mast cells occurs through a non-immune mechanism and is quite weak, but with increased tissue sensitivity to histamine, this leads to the development of erythema and itching. In addition to mechanical factors, an imbalance of the cholinergic autonomic nervous system can provoke the development of urticaria. This causes the development of so-called cholinergic urticaria. In addition to the erythematous rashes and skin itching typical for this pathology, in this case there are also disturbances in sweating and regulation of skin temperature. This type of urticaria is often provoked by a person’s emotional experiences. In addition, urticaria pigmentosa, which is an autoimmune pathology, is close to this skin disease. With it, an increased number of basophils accumulate in the skin tissues, which can be easily activated by various factors.

Description

 Allergic urticaria.

Skin pathology of an allergic nature, which can be acute or (less often) chronic. Its symptoms are skin itching, the appearance of erythematous elements rising above the skin, similar to rashes remaining after a nettle burn - hence the name of the pathology. Diagnosis is made based on an examination of the patient, a blood test, and determination of the level of immunoglobulin E; It is possible to conduct immunological studies - allergy tests to identify the allergen. Treatment of allergic urticaria is carried out using antihistamines, a hypoallergenic diet, and immunomodulatory drugs.