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Chronic Spontaneous Urticaria (CSU) and Homoeopathy

© Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy)

Definition

Urticaria (Psora+++/ Sycosis++/ Syphilis+) is a transient condition of the skin, usually caused by an allergic reaction (Psora), characterized by pale or reddened irregular, elevated patches and severe itching (Psora).

Synonyms

Urtication, urticaria, hives, nettle rash, rash, roseola, efflorescence, skin rash, hypersensitivity reaction.

Urticaria may be acute or chronic.

Acute urticaria

It appears and disappears suddenly without many recurrences. (Psora)

Chronic urticaria

Wheals and/ or angioedema lasting > 6 weeks (Psora/ Sycosis)

Classification of Chronic Urticaria Subtypes

1-     CSU- Spontaneous appearance of wheals (Psora), angioedema (Sycosis), or both >_ 6 weeks due to known or unknown causes. Known causes include infections or auto reactivity (Causa occasionalis/ Tolle causum) i.e. presence of mast cell- activating autoantibodies (Psora).

2-     Inducible Urticaria-

  1. Physical urticaria-

                                                    i.     Symptomatic dermographism- also called urticarial factitia or dermographic urticarial (Psora)

                                                   ii.     Cold urticarial- also called cold contact urticarial (Psora)

                                                  iii.     Delayed pressure urticarial- also called pressure urticarial (Psora)

                                                  iv.     Solar urticarial (Psora)

                                                   v.     Heat urticaria- also called heat contact urticarial (Psora)

Chronic Spontaneous Urticaria (CSU)

It is the type of chronic urticaria which is spontaneous (No external physical stimuli) and has development of wheals, angioedema, or both for > 6 weeks (Psora/ Sycosis)

1-     Wheals

  1. Central swelling of variable size, usually surrounded by a reflex erythema (Psora)
  2. Associated itching or, sometimes, burning sensation (Psora)
  3. Resolve within 1- 24 hours

2-     Angioedema

  1. Sudden, pronounced swelling of the lower dermis and subcutis (Psora/ Sycosis)
  2. Sometimes pain rather than itching (Psora)
  3. Frequent involvement below mucous membranes (Sycosis)
  4. Up to 72 hours for resolution

NB- Wheals resolve as new ones form, such that CSU patients continually have wheals for > 6 weeks

Prevalence of CSU

1-     Urticaria of any type is very common and increasing in incidence

2-     Women to men ratio is 2:1

3-     All age groups are affected but peak incidence is between 20- 40 years of age (Working years)

4-     No relationship between urticaria prevalence and education, income, place of residence or ethnic background

Pathogenesis of CSU

Triggering-

Triggers like- heat, cold, exercise or undefined, including- anphylatoxins, neuropeptides, bacteria, interleukins, chemokines, oxytocin, leukotriene, POMCs (Pro-opiomelanocortin), prostaglandins, cannabinoids, adenosine, urokinase, capsaicin etc. affect- IgE, FCeRI, SCF (Stem Cell Factor), IgG, FcyR, LPS, TLRs (Toll-like receptor), Complement. (Tolle causum/ Causa occasionalis).

These factors work to induce mast cell activity. Mast cells are the key effectors cells in the induction of urticaria symptoms.

Mast cells activity-

Cutaneous mast cells release mediators in response to various factors including drugs, peptides and vasoactive amines (Psora). Mast cells activity leads to the secretion of- IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8, IL-10, IL-13, TNF, MIPs, IFN-y, GM-CSF, TGF-B, bFGF, VPF/VEGF, Pgd2, LTB4, LTC4, PAF, Histamine, serotonin, heparin, chondroitin, sulphate, chymase, tryptase and CPA.

Mast Cell Activity

Symptoms induction and manifestation via mediators-

In turn, these factors induce-

1-     Activation- Pruritus (Psora)

2-     Vasodilatation- Erythema (Psora)

3-     Extravasations- Wheal (Sycosis)

4-     Recruitment- Infiltrate (Psora/ Sycosis)

Signs and symptoms of CSU

Pruritus is usually worse in nights causing sleep deprivation (Psora/ Syphilis) and consequently, chronic fatigue (Psora/ Syphilis). Psychological comorbidities are common with CSU. It affects the person as a whole in following ways-

1-     Daily living- physical activities, chores, eating, concentrating, sleeping. (Psora)

2-     Self-perception- Loneliness, conspicuousness, anxiety about future, feeling unhygienic. (Psora/ Syphilis)

3-     Mental status- Tired, stressed, overwhelmed, and anxious. (Psora/ Sycosis/ Syphilis)

4-     Treatment induced restrictions- Effect on everyday activities, financial burden, and discomfort. (Psora)

5-     Social functions- Impact on relationships, impact on sexuality. (Psora/ Sycosis)

6-     Leisure- Restricted choice of clothing, limited hobbies, avoiding sun exposure. (Psora)

Autoimmunity in CSU

1-     Up to 40% of CSU cases may be autoimmune related. (Psora)

  1. If the threshold for mast cell activation is lowered, patients have a higher susceptibility to histamine release. (Psora/ Sycosis)
  2. A decrease in threshold of mast cell activation occurs in a certain group of patients with CSU, notably those with an autoimmune component. (Psora)

2-     Possible autoimmune pathways in CSU

  1. 60% of patients have an antibody directed against FceRI (Psora)
  2. 10% exhibit IgE anti IgE (Psora)
  3. 30- 40% of patients have histamine releasing autoantibodies directed against high affinity IgE receptor or, less frequently, IgE itself (Psora)
  4. In some patients with IgE, autoantibodies against thyroperoxidase have been identified. (Psora)

Diagnosis of CSU

1-     Routine patient evaluation with thorough history and physical examination with special stress to the following-

  1. Timing, frequency, duration of attacks
  2. Shape, size, distribution and associated symptoms of lesions
  3. Family and medical history including allergies
  4. Observed correlation to any triggers e.g. foods, exercise, drugs etc.
  5. Type of work, hobbies, smoking habits, stress
  6. Previous therapy and response to treatment

2-     Physical examination should include-

  1. Blood tests to rule out any systemic disease
  2. Tests to identify triggers

Identification and elimination of the underlying cause and/ or trigger

1-     In patients with inducible urticaria, identifying and eliminating the cause interrupts the pathogenic process and leads to resolution of the urticaria.

2-     Allergy profile tests can be done. These may include ASST (Autologous Serum Skin Test) or Allergy screening tests by EIA.

Duration of CSU

In most cases, the duration of CSU is estimated 1- 5 years, however in some cases; it may last up to 50 years.

Repertory of Urticaria

ABDOMEN - ERUPTIONS – urticaria merc. nat-c. nat-sal. tub.

Abdomen - ERUPTIONS, abdomen – urticaria merc. nat-c. nat-sal. tub.

ABDOMEN - PAIN - hypochondria - right - urticaria, with astac. myric.

ABDOMEN - PAIN - liver - urticaria, with ars-h. ASTAC. myric. ptel.

Abdomen - PAIN, hypochondria - right, side - urticaria, with astac. myric.

Abdomen – URTICARIA merc. nat-c.

Ankles - ERUPTIONS, ankle - urticaria, ankle Nat-m.

Ankles - URTICARIA, ankles Nat-m.

Arms - URTICARIA, arms acon. ant-c. Apis berb. calad. Carb-v. chinin-s. Chlol. cop. hep. hydrc. hyper. indg. kali-i. lach. lyc. merc. Nat-c. Nat-m. nat-s. Phos. rhus-v. SULPH. thuj. Urt-u.

BACK - ERUPTIONS – urticaria apis apisin. cann-s. choc. cupr-o. lac-ac. lach. lyc. sil. sulph.

Brain - SHAKEN, sensation, as if being - urticaria, in bell.

Breathing - DIFFICULT, breathing - alternating, with – urticaria Calad.

CHEST - COMPLAINTS of chest - Bronchial tubes - accompanied by – urticaria pin-s.

CHEST - ERUPTIONS – urticaria atra-r. CALAD. hydrc. ina-i.  sars. sulph. tub. urt-u.

CHEST - OPPRESSION - alternating with – urticaria CALAD.

CHEST - PALPITATION of heart - accompanied by – urticaria bov.

Chest - URTICARIA, chest Calad. hydrc. sars. sulph. urt-u.

Clinical - allergies, allergic reactions - hives, and swelling, with Acon. agar. all-c. Ant-c. Apis arn. Ars. Astac. bell. Bov. Calad. Carb-ac. chlor. Graph. Hist. Led. Lyc. Mez. Nat-m. Nat-p. nit-ac. Psor. Puls. Rhus-t. Sal-ac. Sul-ac. Sulph. Urt-u. vesp.

Clinical - erysipelas, general - urticaria, with Astac.

Clinical - hives, urticaria Acon. agar. all-c. Ant-c. Apis arn. Ars. Astac. bell. Bov. Calad. Carb-ac. chlor. Graph. Led. Lyc. Mez. Nat-m. Nat-p. nit-ac. Psor. Puls. Rhus-t. Sal-ac. Sul-ac. Sulph. Urt-u. vesp.

Clinical - laryngitis, inflammation - urticaria, with suppressed Ars.

Clinical - Malaria, infection, ague - apyrexia, - urticaria, better  by rubbing elat.

Elbows - ERUPTIONS, elbows - urticaria, elbow aran.

Elbows - URTICARIA, elbow aran.

EXTERNAL THROAT - ERUPTIONS – urticaria bamb-a. bry. kali-i. tax.

EXTREMITIES - EROSIVE GNAWING - Toes - accompanied  by – urticaria sulph.

EXTREMITIES - ERUPTIONS - Ankles – urticaria Nat-m.

EXTREMITIES - ERUPTIONS - Elbows – urticaria aran.

EXTREMITIES - ERUPTIONS - Feet - Sole of – urticaria propr.

EXTREMITIES - ERUPTIONS - Feet – urticaria Calc. sulph.

EXTREMITIES - ERUPTIONS - Fingers – urticaria hep. thuj. urt-u.

EXTREMITIES - ERUPTIONS - Forearms – urticaria am-c. calad. cassia-s. chin. clem. dream-p. lac-e. lyc. Nat-m. sil.

EXTREMITIES - ERUPTIONS - Hands - Back of hands – urticaria  acon. apis berb. cop. hyper. indg. Sulph. thuj.

EXTREMITIES - ERUPTIONS - Hands - Between the fingers – urticaria hyper. merc.

EXTREMITIES - ERUPTIONS - Hands - Palms – urticaria rhus-v. stram.

EXTREMITIES - ERUPTIONS - Hands – urticaria apis berb. bufo Carb-v. Hep. hyper. nat-c. Nat-m. nat-s. Sars. SULPH. Urt-u. ven-m.

EXTREMITIES - ERUPTIONS - Joints – urticaria clem. verat.

EXTREMITIES - ERUPTIONS - Knees - Hollow of knees – urticaria Zinc.

EXTREMITIES - ERUPTIONS - Knees – urticaria zinc.

EXTREMITIES - ERUPTIONS - Legs - Calves – urticaria carb-v.

EXTREMITIES - ERUPTIONS - Legs – urticaria Calc. Chlor. cypra-eg. dream-p. marb-w. rhus-t. sulfonam. SULPH.

EXTREMITIES - ERUPTIONS - Lower limbs – urticaria Apis Aur. Calc. CHLOL. clem. kali-i. marb-w. merc. plan. sulph. zinc.

EXTREMITIES - ERUPTIONS - Nates – urticaria hydr. lyc.

EXTREMITIES - ERUPTIONS - Shoulders – urticaria lach.

EXTREMITIES - ERUPTIONS - Thighs – urticaria all-c. caust. clem. iod. lac-leo. merc. sulph. Zinc.

EXTREMITIES - ERUPTIONS - Upper arms – urticaria sulfonam.

EXTREMITIES - ERUPTIONS - Upper limbs – urticaria acon. ant-c. Apis berb. calad. cann-s. Carb-v. chinin-s. Chlol. cop. dulc. hep. hydrc. hyper. indg. kali-i. lach. lyc. merc. morg-g. Nat-c. Nat-m. nat-s. Phos. rhus-v. SULPH. thuj. Urt-u.

EXTREMITIES - ERUPTIONS – urticaria acon. all-c. am-c. ant-c. APIS aran. arum-d. BELL. berb. bufo calad. CALC. cann-s. caps. carb-v. cassia-s. caust. chin. chinin-s. CHLOL. chlor. clem. COP. crot-c. cub. cypra-eg. dulc. harp. hep. hydr. hydrc. hyper. indg. iod. kali-br. kali-i. lac-e. LACH. lyc. lycps-v. mand. marb-w. med. merc. morg-g. nat-c. NAT-M. nat-s. phos. plan. RHUS-T. RHUS-V. sars. sil. spig. stann. stram. SULPH. tarax. thuj. URT-U. verat. zinc.

EXTREMITIES - ERUPTIONS - Wrists – urticaria hep. stann.

EXTREMITIES - PAIN - rheumatic - alternating with – urticaria Urt-u.

EXTREMITIES - PAIN - rheumatic - hives, with urt-c.

EXTREMITIES - PAIN - rheumatic - lower limbs - urticaria, with urt-u.

FACE - ERUPTIONS – angioedema apis

FACE - ERUPTIONS – urticaria anan. ant-c. APIS apisin. ars-i. ARS. BELL. CALC. CHEL. chin. chinin-s. CHLOL. coca cop. crot-t. dulc. GELS. HEP. hydr. jug-c. KALI-I. lach. LED. lim. mag-m. medus. mez. NAT-M. nit-ac. plan. prim-o. RHUS-T. SEP. sil. SULPH. URT-U.

FACE - SWELLING - Lips – angioedema apis

Face - URTICARIA, face Am-c. anan. APIS ARS. Bell. Calc. Chel. Chinin-s. CHLOL. COP. crot-t. dulc. Gels. Hep. hydr. Kali-i. lach. Led. mez. Nat-m. nit-ac. Rhus-t. Sep. sil. SULPH. Urt-u.

Feet - URTICARIA, feet Calc. sulph.

Fevers - ERUPTIONS, with fevers – urticaria apis Cop. SULPH. Urt-u.

Fevers - INTERMITTENT, fever, ague, malaria - apyrexia - urticaria, better by rubbing elat.

GENERALITIES - URTICARIA, after APISIN. ARS. cop. URT-U.

GENERALS - HISTORY; personal - urticaria; of recurrent hep. stroph-h.

GENERALS - PAIN - rheumatic - accompanied by – urticaria pin-s. Urt-u.

Hands - ERUPTIONS, hands - fingers, between the – urticaria hyper. merc.

Hands - URTICARIA, hands Apis berb. bufo Carb-v. Hep. hyper. nat-c. Nat-m. nat-s. Rhus-t. Sars. SULPH. Urt-u.

HEAD - ERUPTIONS – urticaria AGAR. Apis APISIN. rhus-t. puls-n. urt-u.

HEAD - PAIN - pressing - urticaria amel., appearance of ap-g.

HEAD - PAIN - urticaria amel., appearance of ap-g.

Head - URTICARIA, head Agar.

Joints - URTICARIA, joints clem. rhus-t. urt-u. verat.

Knees - ERUPTIONS, knee - hollow, of – urticaria Zinc.

Knees – URTICARIA zinc.

Larynx - LARYNGITIS, inflammation - urticaria, with suppressed Ars.

LARYNX & TRACHEA - INFLAMMATION - larynx - urticaria, with suppressed ARS.

LARYNX AND TRACHEA - CROUP - alternating with – urticaria ars.

LARYNX AND TRACHEA - INFLAMMATION - Larynx - urticaria; suppressed Ars.

LARYNX AND TRACHEA - SWELLING - Larynx -  angioedema apis

Legs - URTICARIA, legs Apis Calc. CHLOL. clem. kali-i. merc. plan. sulph. zinc.

Limbs - URTICARIA, limbs acon. ant-c. Apis Bell. berb. Calc. chinin-s. CHLOL. Cop. dulc. hydrc. hyper. indg. kali-br. kali-i. Lach. lyc. merc. Nat-m. Rhus-t. Rhus-v. Sulph. tarax. Urt-u.

Liver - PAIN, liver - urticaria, with ars-h. Astac. myric. ptel.

Lungs - ASTHMA, general - alternating, with – urticaria calad.

Lungs - ASTHMA, general - hives, from apis puls.

MALE - ERUPTIONS – urticaria clem. cop. lyc. merc. nat-c.

Male - ERUPTIONS, genitalia – urticaria clem. cop. lyc. merc. nat-c.

Male - URTICARIA, genitalia clem. cop. merc. nat-c.

MALE GENITALIA/SEX - ERUPTIONS – urticaria clem. cop. merc. nat-c.

Mind - ABSENT-minded - urticaria, in Bov.

MIND - AVERSION - everything, to - urticaria, in bov.

MIND - AWKWARDNESS - urticaria, in BOV.

MIND - DELIRIUM - urticaria, in COP.

Mind - QUARRELSOME, disposition - urticaria, in Bov.

MIND - QUARRELSOMENESS, scolding - urticaria, in BOV.

MIND - SENSITIVE - urticaria, in Bov.

MIND - SENSITIVE, oversensitive - general - urticaria, in BOV.

MOUTH - SWELLING - Tongue – angioedema apis

Neck - URTICARIA, neck, front bry. kali-i.

NOSE - CATARRH - accompanied by – urticaria all-c. dulc.

Pelvis - URTICARIA, buttocks hydr. lyc.

Pulse - FAST, pulse, elevated, exalted - urticaria, in, 104 rhus-t.

RECTUM - CONSTIPATION - urticaria, with cop.

RESPIRATION - ASTHMATIC - alternating with - eruptions – urticaria calad. crot-t.

RESPIRATION - ASTHMATIC - hives, from apis puls.

RESPIRATION - DIFFICULT - alternating with – urticaria apis Calad.

Shoulders – URTICARIA lach.

SKIN - ERUPTIONS – angioedema agar. Anac. antip. apis bacls-7. bol-lu. calc-m. hell. hep. kali-i. pitu-p. prot. santin. vesp.

SKIN - ERUPTIONS - blotches - red – urticaria APIS

SKIN - ERUPTIONS - blotches - white - urticaria, like APIS

SKIN - ERUPTIONS - urticaria, hives - sequelae, from suppressed hives, with apis urt-u.

SKIN - ERUPTIONS - urticaria, hives ACON. aegle-f. agar. all-c. alum. alumin-p. alumin-sil. am-c. am-m. amyg. anac. ANT-C. ant-t. anthraco. ANTIP. ap-g. APIS APISIN. arn. ARS-I. ARS-S-F. ARS. arum-d. ASTAC. aur-ar. aur-s. aur. bar-c. bar-m. bar-s. bart. bell-p. BELL. benz-ac. berb-a. berb. bol-la. bol-lu. bomb-chr. bomb-pr. BOV. BRY. bufo CALAD. calc-lac. calc-p. CALC-S. calc-sil. CALC. camph. cann-s. canth. caps. carb-an. CARB-V. CARBN-S. cassia-s. cath-a. CAUST. cham. chel. chin. chinin-ar. CHININ-S. CHLOL. chlor. chloram. chlorpr. chol. cic. cimic. cina cob-n. coca cocc. CON. COP. CORN. cortico. crot-c. CROT-H. crot-t. cub. cund. cupr-act. cupr-o. CUPR. cypr. cypra-eg. dig. dol. dros. DULC. dys. echi. ELAT. EPHE. fago. ferr-i. form. FRAG. gaert. gal-ac. GALPH. gast. gels. GRAPH. guar. harp. helia. hell. HEP. hist. hom-g. hydr. ICHTH. IGN. iod. ip. jug-c. KALI-AR. KALI-BR. KALI-C. kali-chl. kali-i. kali-n. kali-p. kali-s. kali-sil. kola KREOS. lach. lam. LED. lepr. linu-u. lob. loxo-recl. LYC. lycps-v. mag-c. mag-m. mang. med. medus. merc. MEZ. moni. morg-g. morph. mur-ac. myric. nat-ar. NAT-C. nat-f. NAT-M. NAT-P. nat-s. nat-sal. nat-sil. NIT-AC. NUX-V. olnd. op. ox-ac. pall. PETR. ph-ac. PHOS. physal-al. phyt. pic-ac. pin-s. pip-n. pitu-p. podo. polyg-h. pot-a. prim-o. PSOR. ptel. puls-n. PULS. ran-b. rheum RHUS-T. rhus-v. rob. rumx. ruta sabin. SAL-AC. sang. sanic. santin. saroth. SARS. sec. sel. SEP. sil. skook. sol-a. spig. spong. squil. stann. staph. stram. stroph-h. stry-xyz. SUL-AC. SUL-I. sulfa. sulo-ac. SULPH. tarax. tarent-c. tarent. tela ter. term-a. tet. THUJ. TIL. TRIOS. tub. URT-U. ust. uva valer. vario. VERAT. verb. verin. vesp. viol-t. voes. wies. zinc-phic. zinc.

SKIN - ERYSIPELAS - accompanied by – urticaria astac. frag.

SKIN - ERYSIPELAS - urticaria, with ASTAC.

SKIN - SWELLING - general - urticaria, like nat-p.

Skin - URTICARIA, hives - sequelae, from suppressed hives, with apis urt-u.

SKIN AND EXTERIOR BODY - Eruptions - urticarious (nettle-rash) ACON. am-c. Am-m. Anac. ANT-C. ant-t. APIS ARS. bar-c. BELL. berb. Bov. BRY. bufo CALC. camph. carb-an. Carb-v. CAUST. Chin. cic. cocc. CON. cop. crot-t. DULC. Form. graph. HEP. Ign. Ip. kali-br. kali-c. kali-m. kreos. lach. led. LYC. mag-c. Merc. MEZ. Nat-c. NAT-M. nat-p. nat-s. nit-ac. Nux-v. op. PETR. ph-ac. phos. pic-ac. pip-n. psor. PULS. RHUS-T. rob. rumx. ruta sabin. sars. Sec. sel. SEP. Sil. staph. stram. SULPH. Ter. thuj. Urt-u. UST. valer. VERAT. zinc.

STOMACH - DISORDERED - urticaria; after cop.

STOMACH - INDIGESTION - accompanied by – urticaria Ant-c. ars. carb-v. cop. dulc. nux-v. Puls. rob. trios.

STOMACH - INDIGESTION - urticaria, from cop.

Stomach - INDIGESTION, general - urticaria, from cop.

STOMACH - NAUSEA - accompanied by - itching of skin -  urticaria; before sang.

STOMACH - NAUSEA - itching - with, before urticaria sang.

Stomach - NAUSEA, general - itching, scratch, has to, until he vomits - urticaria, before sang.

Stomach - NAUSEA, general - urticaria, preceeding sang.

STOMACH - PAIN - pressing - urticaria, before ap-g.

STOMACH - PAIN - urticaria, before ap-g.

Stomach - PRESSING, pain - urticaria, before ap-g.

Stomach - URTICARIA, stomach problems, after cop.

Stomach - VOMITING, general - urticaria, during Apis cina

Throat - ERUPTIONS, throat - throat, external – urticaria bry. kali-i.

THROAT - INFLAMMATION, sore throat - urticaria, with apis dulc.

THROAT - SWELLING – angioedema APIS

Vaccinations - ALLERGIC, reactions - hives, and swelling, with Acon. agar. all-c. Ant-c. APIS arn. ARS. ASTAC. bell. Bov. Calad. CARB-AC. chlor. Graph. HIST. LED. Lyc. Mez. NAT-M. Nat-p. nit-ac. Psor. Puls. RHUS-T. Sal-ac. Sul-ac. SULPH. URT-U. vesp.

Bibliography

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Angioedema and Urticaria CURRENT Diagnosis & Treatment Emergency Medicine, 7e > Chapter 48. Dermatologic Emergencies > Immediate Recognition and Management of Life-Threatening Problems

Certain allergic dermatoses respond favorably to H1 antagonists. The benefit is most... Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e > Chapter 32. Histamine, Bradykinin, and Their Antagonists > H1 Receptor Antagonists > Therapeutic Uses > Allergic Diseases

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Chapter 317 Allergies, Anaphylaxis, and Systemic Mastocytosis Harrison’s Lecture Notes

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Diagnosis Harrison’s Online > Chapter 317. Allergies, Anaphylaxis, and Systemic Mastocytosis

Drug-Induced Acute Urticaria, Angioedema, Edema, and Anaphylaxis Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology > Section 22. Adverse Cutaneous Drug Reactions

Figure 170-12. Urticarial drug reaction with annular lesions that are often mistaken for EM. Note... The Color Atlas of Family Medicine > Chapter 170. Erythema Multiforme, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis > Differential Diagnosis

Figure 180-1. Urticaria on a forearm from local histamine release due to IV morphine. (Courtesy...Tintinalli’s Emergency Medicine > Chapter 180. Opioids > Clinical Features

Figure 51-11. Urticaria. Discrete and confluent, edematous, erythematous papules and plaques... Harrison’s Online > Chapter 51. Approach to the Patient with a Skin Disorder > Approach to the Patient with a Skin Disorder: Introduction > Diagnostic Techniques > Diascopy

Figure e16-14. A. Urticaria showing characteristic discrete and confluent,... Harrison’s Online > Chapter e16. Atlas of Skin Manifestations of Internal Disease > Common Skin Diseases and Lesions

Figure e7-36. Urticaria showing characteristic discrete and confluent, edematous,... Harrison’s Online > Chapter e7. Atlas of Rashes Associated With Fever > Atlas of Rashes Associated with Fever

Inflammation confined to the superficial connective tissue–vascular unit is characterized by... Fitzpatrick’s Dermatology in General Medicine, 8e > Chapter 6. Basic Pathologic Reactions of the Skin > Reticular Dermis

Key Sign Urticaria DeGowin’s Diagnostic Examination > Chapter 6. The Skin and Nails > Skin and Nail Signs > Generalized Skin Signs

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Radar 10

Section 9. Alterations in the Skin Harrison’s Lecture Notes

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Urticaria Harrison’s Online > Chapter 53. Skin Manifestations of Internal Disease

Urticaria Principles and Practice of Hospital Medicine > Chapter 177. Transfusion of Blood Components, Derivatives and Their Adverse Effects > Complications of Transfusion

Urticaria Symptom to Diagnosis: An Evidence-Based Guide, 2e > Chapter 24. I Have a Patient with a Rash. How Do I Determine the Cause? > Other Important Cutaneous Disorders

Urticaria The Atlas of Emergency Medicine > Chapter 14. Pediatric Conditions > Rashes and Lesions

Urticaria Tintinalli’s Emergency Medicine > Chapter 249. Skin Disorders Common on the Trunk > Morbilliform/Urticarial Eruptions

Urticaria, Angioedema, and Anaphylaxis Principles and Practice of Hospital Medicine > Chapter 142. Adverse Cutaneous Drug Reactions > Does This Patient Have an Adverse Cutaneous Drug Reaction? > The Patient with Cutaneous Findings and Signs of End Organ Damage

Urticaria/Angioedema Harrison’s Online > Chapter 55. Cutaneous Drug Reactions > Clinical Presentation of Cutaneous Drug Reactions > Immune Cutaneous Reactions: Benign

Urticarial Eruptions Fitzpatrick’s Dermatology in General Medicine, 8e > Chapter 41. Cutaneous Reactions to Drugs > Morphologic Approach to Drug Eruptions

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Tags: (CSU), Chronic, Homoeopathy, Spontaneous, Urticaria, and, angioedema, dr., hives, homeopath, More…homeopathy, homoeopath, india, kashipur, nettle, rajneesh, rash

Comment by Dr Muhammed Rafeeque on December 21, 2013 at 10:10pm

we often get failed cases from modern medicine. Our drugs work magically for such cases.

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on December 21, 2013 at 10:34pm

That is true. Thanks...

Comment by Debby Bruck on January 7, 2014 at 9:24am
Can this repertory be helpful for someone with shingles?
Comment by Dr Rajneesh Kumar Sharma MD(Hom) on January 7, 2014 at 10:28pm

Dear Debby, Thanks for this question. This repertory is not for shingles. I have already published a repertory of Herpes zoster at HWC for this purpose. Best of regards.

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