Acute Hives - Cholinergic Hives

Acute hives is defined as the presence of momentary wheals, which mostly resolve within a few hours after appearing. Cholinergic hives is a skin rash brought on by a hypersensitive reaction to body heat. It is actually a subcategory of physical urticaria. Hives rash caused by both acute and cholinergic hives are very itchy and painful.

Cholinergic hives symptoms follow any stimulus to sweat, such as running or exercise, heat from the direct sunlight, and high temperature saunas, as well as spicy foods, which may cause an increase in body temperature, very hot showers, or sometimes extreme stress due to blushing or anger. In some cases, individuals only have symptoms during the winter season where their body temperature rises when it is un-acclimatized to heat.

Acute hives usually occur in response to certain allergies and it is believed that 15-20% of the population suffers from acute urticaria at some point in their lives. A few minutes after the person has been exposed to the allergen, acute urticaria becomes apparent. It may last several weeks in some cases, but mostly it vanishes within a few hours. Normally, the hives is a reaction to food, but in 50% of the cases, the trigger is unknown and is called idiopathic hives. Besides foods, bee or wasp stings, or skin contact with certain fragrances can also be the triggers.

Acute hives mostly affect infants and children. Causes of acute hives in children include Idiopathic (unknown) causes, allergen infections, foods, and drugs. Nearly half of the children with acute urticaria have evidence of functional auto-antibodies.

If a child is suffering from acute hives, the causes should be avoided as much as possible. H1 antihistamines, i.e. classical and second generation can be used. In some cases, H2 antihistamines can also be given. Oral corticosteroids have also been found useful. Epinephrine should be given for anaphylaxis only; however, if the urticaria is hereditary, epinephrine may not be as useful.