Akut Ürtiker

immunoloji alerji ozel 13-2 kapak

Cengiz KIRMAZa
aManisa Celal Bayar Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Hastalıkları BD, Manisa, TÜRKİYE

Kırmaz C. Akut ürtiker. Çildağ S, editör. İmmünolojik ve Alerjik Deri Hastalıkları. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.7-13.

ÖZET
Ürtiker, eritematöz ve çoğunlukla şiddetli kaşıntılı, hafif kabarık papül veya plakların varlığı ile seyreden vasküler bir cilt reaksiyonudur. Lezyonlar genel olarak birkaç saat içinde iz bırakmadan iyileşir. 6 haftadan kısa süren ürtiker ataklarına ‘akut ürtiker’ denilmektedir. Genel olarak sistemik reaksiyon olmadan izole bir olaydır. Nadiren de anafilaktik bir reaksiyonun başlangıcının habercisi olabilir. Genellikle ayrıntılı hasta öyküsü ve fizik muayene ile tanı alır. Bazen tanıyı ve nedenselliği kanıtlamak için laboratuvar testleri kullanılır. Klinik olarak farklı olmasına rağmen, ürtiker, atopik dermatit (egzama), makülopapüler ilaç döküntüleri, kontak dermatit, böcek ısırıkları, eritema multiforme, pityriasis rosea ile karıştırılabilir. Antihistaminikler, ürtiker tedavisinde kullanılan birincil ajanlardır. İkinci jenereasyon anti-histaminikler temel olarak yeterli olur; nadiren günlük dozun dört katını kadar çıkmak gerekebilir. Bazı hastalarda H2-antagonitlerinin H1-antagonislerine eklenmesi tedavi etkinliğini arttırmaktadır. Anti-histaminiklere dirençli vakalarda 5-7 gün gibi kısa süreli peroral ya da tek doz uzun etkili parenteral kortikosteroidler kullanılabilir. Bunun dışında nadir bir grupta trisiklik anti-depresanlar işe yaramaktadır.

Anahtar Kelimeler: Akut ürtiker; tanı; ayırıcı tanı; tedavi

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