What are the main symptoms of internal hives. How do urticaria and angioedema differ. What are the common causes of hives and angioedema. How are these conditions diagnosed and treated. What are the key tips for managing hives at home. When should you seek immediate medical attention for hives.

Understanding Hives (Urticaria) and Their Manifestations

Hives, medically known as urticaria, are a common skin condition characterized by the sudden appearance of swollen, pale red bumps or welts on the skin. These raised patches can vary significantly in size, ranging from as small as a pencil eraser to as large as a dinner plate. On darker skin tones, hives may appear skin-colored, making them more challenging to identify visually.

The primary symptoms of hives include:

• Itching (which can be intense)
• Burning or stinging sensations
• Rapid changes in size and location
• Potential to merge into larger areas called plaques

Hives can appear anywhere on the body, including sensitive areas such as the face, lips, tongue, throat, and ears. One of the most distinctive features of hives is their transient nature – they can appear, disappear, and reappear in different locations within hours.

Duration and Recurrence of Hives

How long do hives typically last? The duration of hives can vary greatly from person to person. Some individuals may experience a single episode that resolves within a few hours, while others may have recurrent flare-ups that persist for weeks, months, or even years. This variability in duration and frequency can make hives a challenging condition to manage for some patients.

Angioedema: The Deeper Cousin of Hives

While hives affect the surface of the skin, angioedema involves swelling in the deeper layers of skin and subcutaneous tissues. This condition often accompanies hives but can also occur independently.

Key characteristics of angioedema include:

• Deep swelling, particularly around the eyes and lips
• Potential involvement of the genitals, hands, and feet
• Longer duration compared to hives (usually less than 24 hours)
• Rare but serious cases affecting the throat, tongue, or lungs

Is angioedema more dangerous than hives? While both conditions can be uncomfortable, angioedema can potentially be more serious, especially if it affects the airways. Swelling in the throat, tongue, or lungs can obstruct breathing, making it a medical emergency that requires immediate attention.

The Underlying Mechanisms: What Causes Hives and Angioedema?

At the core of both hives and angioedema is the release of histamine and other inflammatory chemicals in the body. This release can be triggered by various factors, including:

1. Allergic reactions to foods, medications, or environmental substances
2. Exposure to certain chemicals in foods
3. Insect stings or bites
4. Sunlight exposure
5. Certain medications

When histamine is released, it causes small blood vessels in the skin to leak, resulting in localized swelling and inflammation. This process manifests as hives on the skin’s surface or as deeper swelling in the case of angioedema.

The Mystery of Idiopathic Hives

In many cases, the exact cause of hives remains unknown, a condition referred to as idiopathic urticaria. This can be frustrating for both patients and healthcare providers, as identifying and avoiding triggers is a key part of managing the condition.

Types of Urticaria and Angioedema: Acute vs. Chronic

Urticaria and angioedema can be classified based on their duration and underlying causes. Understanding these classifications is crucial for proper diagnosis and treatment.

Acute Urticaria and Angioedema

What defines acute urticaria? Acute cases are characterized by hives or swelling that last less than six weeks. Common triggers for acute urticaria include:

• Foods (especially nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk)
• Medicines (such as aspirin, NSAIDs, ACE inhibitors, and codeine)
• Latex exposure
• Infections (viral, bacterial, or fungal)
• Insect bites

It’s worth noting that fresh foods are more likely to cause hives than cooked foods, and certain food additives and preservatives may also be culprits.

Chronic Urticaria and Angioedema

How is chronic urticaria different from acute cases? Chronic urticaria is defined as hives or swelling that persists for more than six weeks. The causes of chronic cases are often more elusive and may include:

• Immune system disorders
• Chronic infections
• Hormonal imbalances
• Tumors (in rare cases)

Identifying the underlying cause in chronic cases often requires more extensive investigation and may involve a multidisciplinary approach.

Physical Urticaria: When External Factors Trigger Hives

Physical urticaria is a unique subset of hives caused by direct physical stimulation of the skin. These hives typically appear within an hour of exposure to the triggering stimulus and are usually localized to the affected area.

Common triggers for physical urticaria include:

• Cold exposure
• Heat
• Sunlight
• Vibration
• Pressure
• Sweating
• Exercise

Dermatographism: Writing on the Skin

Dermatographism is a fascinating form of physical urticaria where hives develop after firmly stroking or scratching the skin. This condition, whose name literally means “skin writing,” can sometimes coexist with other forms of urticaria.

Hereditary Angioedema: A Genetic Form of Swelling

Hereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of severe swelling. Unlike other forms of angioedema, HAE is not caused by an allergic reaction but by a deficiency or dysfunction of a protein called C1 inhibitor.

Key features of hereditary angioedema include:

• Painful swelling under the skin
• Family history of similar symptoms
• Potential for life-threatening swelling of the airways
• Specific treatment protocols different from those for allergic angioedema

Diagnosing Hives and Angioedema: A Detective’s Work

Diagnosing the underlying cause of hives and angioedema often requires a combination of medical detective work and targeted testing. The process typically involves:

1. Detailed medical history: Your doctor will ask numerous questions about your symptoms, potential triggers, and overall health.
2. Physical examination: A thorough skin examination helps characterize the hives and identify any associated symptoms.
3. Allergy testing: Skin prick tests or blood tests may be performed to identify potential allergic triggers.
4. Blood tests: These can help rule out underlying systemic conditions or identify specific markers associated with certain types of urticaria.

In some cases, additional specialized tests may be necessary, particularly for chronic or recurrent cases where the cause remains elusive.

The Challenge of Diagnosing Chronic Urticaria

Why is chronic urticaria often more difficult to diagnose? Chronic cases often have more complex underlying causes that may not be immediately apparent. Diagnosis may require a process of elimination and could involve consultation with specialists in allergy/immunology, dermatology, or other relevant fields.

Treatment Approaches: Managing Hives and Angioedema

The primary goal in treating hives and angioedema is to alleviate symptoms and prevent recurrences. Treatment strategies often involve a combination of trigger avoidance and medication.

Identifying and Avoiding Triggers

The most effective treatment is to identify and eliminate the triggering factor. However, this is not always possible, especially in cases of chronic or idiopathic urticaria.

Medication Options

What are the main medications used to treat hives and angioedema?

• Antihistamines: These are the first-line treatment for most cases of urticaria. They help reduce itching and prevent hive formation.
• Corticosteroids: For severe cases, short courses of oral steroids may be prescribed.
• Epinephrine: In cases of severe angioedema, especially those affecting the airways, epinephrine (adrenaline) may be necessary.
• Biologic drugs: For chronic cases that don’t respond to antihistamines, newer biologic medications like omalizumab may be considered.

Treatment for Chronic Urticaria

Chronic urticaria often requires a more complex treatment approach. This may involve:

• Higher doses of antihistamines
• Combination therapy with multiple medications
• Longer treatment durations
• Regular follow-ups to adjust treatment as needed

Self-Care Strategies: Managing Hives at Home

While medical treatment is often necessary, there are several self-care measures that can help manage symptoms and provide relief:

1. Use cool compresses or wet cloths on affected areas to soothe itching and burning.
2. Take lukewarm baths or showers, avoiding hot water which can exacerbate symptoms.
3. Wear loose-fitting, lightweight clothing to minimize skin irritation.
4. Keep your environment cool, as heat and sweating can trigger or worsen hives.
5. Apply over-the-counter anti-itch medications like calamine lotion.
6. Use fragrance-free moisturizers to prevent skin dryness, which can increase itching.
7. Consider over-the-counter antihistamines for mild cases, following package instructions.

The Importance of Stress Management

How does stress affect hives? While stress itself doesn’t cause hives, it can exacerbate symptoms and trigger flare-ups in some individuals. Incorporating stress-reduction techniques such as meditation, deep breathing exercises, or yoga may help manage symptoms in stress-sensitive individuals.

When to Seek Immediate Medical Attention

While most cases of hives and angioedema are not life-threatening, there are situations where immediate medical care is crucial. Seek emergency medical attention if you experience hives or angioedema along with any of the following symptoms:

• Difficulty breathing or wheezing
• Swelling of the tongue or throat
• Dizziness or fainting
• Chest tightness or pain

These symptoms may indicate a severe allergic reaction (anaphylaxis) or angioedema affecting the airways, both of which can be life-threatening if not treated promptly.

The Role of Emergency Epinephrine

For individuals with a history of severe allergic reactions or angioedema, carrying an epinephrine auto-injector (such as an EpiPen) can be lifesaving. If prescribed, ensure you understand how and when to use it, and always keep it readily available.

Understanding hives and angioedema, their causes, and appropriate management strategies is crucial for anyone affected by these conditions. While they can be distressing and sometimes challenging to manage, most cases can be effectively controlled with proper medical care and self-management techniques. If you’re experiencing recurrent or severe symptoms, don’t hesitate to consult with a healthcare professional for personalized advice and treatment.

Hives, Urticaria, and Angioedema: Symptoms, Causes, and Treatment

Written by WebMD Editorial Contributors

• Causes
• Types
• Diagnosis
• Treatment
• 7 Simple Tips
• When Should I Call the Doctor?
• More

Hives are swollen, pale red bumps, patches, or welts on the skin that appear suddenly. On darker skin tones, they can appear skin-colored and can be more difficult to see. They can happen because of allergies or other reasons. Your doctor may call them urticaria.

Hives usually itch, but they may also burn or sting. They can show up anywhere on your body, including the face, lips, tongue, throat, and ears. Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours. Hives can often appear and then clear up within a few hours. Some people have one flare-up and never get hives again. It’s also possible to have many flare-ups.

They range in size from a pencil eraser to a dinner plate and may join together to form larger areas known as plaques. They can last for hours, weeks, or even years.

Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.

Sometimes, doctors don’t know exactly why hives have formed.

Urticaria, also known as hives, is a skin rash of raised, itchy bumps. The welts may also burn or sting. They often last hours or days, can move around, and don’t leave lasting skin changes. Viral, bacterial, or fungal infections may trigger hives, and they frequently happen again.

Acute urticaria and/or angioedema: With these conditions, hives or swelling lasts less than 6 weeks. The most common causes are foods, medicines, latex, and infections. Insect bites or a disease may also be responsible.

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Drugs that can cause hives and angioedema include aspirin and other NSAIDs (such as ibuprofen), high blood pressure medications (such as ACE inhibitors), and painkillers such as codeine.

Chronic urticaria and/or angioedema: Hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.

Physical urticaria: Hives caused by direct physical stimulation of the skin – for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.

Dermatographism: Hives that form after firmly stroking or scratching the skin. You may also have other forms of hives.

Hereditary angioedema: Painful swelling under the skin. It runs in families.

Your doctor will ask you many questions to try to find the cause of hives or angioedema. You’ll also get a checkup.

Your doctor may give you skin tests to find out if you’re allergic to something. You may get blood tests, too.

The best treatment is to identify and remove the trigger. But that’s not always easy.

Your doctor may prescribe antihistamines to ease your symptoms or help prevent them.

If you have chronic hives, you may need antihistamines or a combination of medications, such as steroids or a biologic drug.

For severe hives or angioedema, you may need a shot of epinephrine or a steroid medication.

While you wait for the hives and swelling to disappear:

1. Avoid hot water. Use lukewarm water instead.
2. Use gentle, mild soap.
3. Apply cool compresses or wet cloths to the affected areas.
4. Try to work and sleep in a cool room.
5. Wear loose-fitting lightweight clothes.
6. Use anti-itch medication that you can get without a prescription, such as an antihistamine or calamine lotion.
7. Apply a fragrance-free moisturizer several times a day to keep your skin from getting dry.

If you have hives or angioedema and any of the following symptoms, call your doctor right away:

• Dizziness
• Wheezing
• Trouble breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

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Hives, Urticaria, and Angioedema: Symptoms, Causes, and Treatment

Written by WebMD Editorial Contributors

• Causes
• Types
• Diagnosis
• Treatment
• 7 Simple Tips
• When Should I Call the Doctor?
• More

Hives are swollen, pale red bumps, patches, or welts on the skin that appear suddenly. On darker skin tones, they can appear skin-colored and can be more difficult to see. They can happen because of allergies or other reasons. Your doctor may call them urticaria.

Hives usually itch, but they may also burn or sting. They can show up anywhere on your body, including the face, lips, tongue, throat, and ears. Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours. Hives can often appear and then clear up within a few hours. Some people have one flare-up and never get hives again. It’s also possible to have many flare-ups.

They range in size from a pencil eraser to a dinner plate and may join together to form larger areas known as plaques. They can last for hours, weeks, or even years.

Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.

Sometimes, doctors don’t know exactly why hives have formed.

Urticaria, also known as hives, is a skin rash of raised, itchy bumps. The welts may also burn or sting. They often last hours or days, can move around, and don’t leave lasting skin changes. Viral, bacterial, or fungal infections may trigger hives, and they frequently happen again.

Acute urticaria and/or angioedema: With these conditions, hives or swelling lasts less than 6 weeks. The most common causes are foods, medicines, latex, and infections. Insect bites or a disease may also be responsible.

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Drugs that can cause hives and angioedema include aspirin and other NSAIDs (such as ibuprofen), high blood pressure medications (such as ACE inhibitors), and painkillers such as codeine.

Chronic urticaria and/or angioedema: Hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.

Physical urticaria: Hives caused by direct physical stimulation of the skin – for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.

Dermatographism: Hives that form after firmly stroking or scratching the skin. You may also have other forms of hives.

Hereditary angioedema: Painful swelling under the skin. It runs in families.

Your doctor will ask you many questions to try to find the cause of hives or angioedema. You’ll also get a checkup.

Your doctor may give you skin tests to find out if you’re allergic to something. You may get blood tests, too.

The best treatment is to identify and remove the trigger. But that’s not always easy.

Your doctor may prescribe antihistamines to ease your symptoms or help prevent them.

If you have chronic hives, you may need antihistamines or a combination of medications, such as steroids or a biologic drug.

For severe hives or angioedema, you may need a shot of epinephrine or a steroid medication.

While you wait for the hives and swelling to disappear:

1. Avoid hot water. Use lukewarm water instead.
2. Use gentle, mild soap.
3. Apply cool compresses or wet cloths to the affected areas.
4. Try to work and sleep in a cool room.
5. Wear loose-fitting lightweight clothes.
6. Use anti-itch medication that you can get without a prescription, such as an antihistamine or calamine lotion.
7. Apply a fragrance-free moisturizer several times a day to keep your skin from getting dry.

If you have hives or angioedema and any of the following symptoms, call your doctor right away:

• Dizziness
• Wheezing
• Trouble breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

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Internal dimensions of the hive

bee hive | Agricultural sector

Modern beekeeping began to develop with the invention of a collapsible frame hive. For the first time, a frame-type hive for bees was invented in 1814 by the beekeeper P.I. Prokopovich and he also organized the first beekeeping school for peasants in Russia. After the war years, it was decided to introduce uniform requirements for the manufacture of hives, which include:

1. Requirements for the hive as a home for bees.

– external temperature fluctuations should not drastically affect the temperature inside the hive. To achieve this requirement in the manufacture of hives, it is necessary to use materials with high thermal insulation, as well as to use the installation of double walls and filling voids with thermal insulation material.

– the hive should always be dry. In order to prevent dampness, there must be proper ventilation of the hive through tap-holes, a non-leaking roof, and proper insulation.

– the volume of the hive must be sufficient to accommodate a strong family in it during the period of its highest development and, if necessary, be able to expand.

2. Technical and economic requirements.

– the hive should be easy to use

– relatively inexpensive and durable

Basically, when choosing a hive, beekeepers choose two types of hives – single-hull (beds) and multi-hull hives (risers), which in turn differ in the type of construction.

Very convenient in beekeeping is the so-called hive bed. It is a rectangular box. Since hives are the easiest to use, they are recommended for beginner beekeepers. The main convenience lies in the fact that free access to any frame of the hive is provided without dismantling the entire nest, so it is much easier to carry out anti-swarm measures based on the temporary separation of the family. Family expansion occurs horizontally by installing new frames on the side of the nest; it is very convenient to use helper queens to strengthen and build up the family. Due to the convenience and accessibility of expanding the hive, this design allows you to grow a fairly strong family, thereby increasing the collection of marketable honey. A typical hive design is designed for 16-30 nesting frames. In the back and front walls of the hive there are deep internal folds for hanging nesting frames i.e. the principle of placing the frames is presented in the form of a cold skid (the frames are installed with the butt to the notch), which has its advantages during the main honey plant (it facilitates the movement of bees along the frames and provides the best ventilation of the hive)

No less common is a multi-hull hive for bees, which belong to the riser hives. They consist of a main body and additional vertical cases or magazine extensions. Root hives and Dadan-Blatt hives are considered typical risers. Up to 12 cell frames are placed in the hive bodies. It is believed that this design allows you to increase the productivity of the family by 10-20%

Dadan-Blatt hives are very popular in our country. It got its name as a result of the refinement of the Dadan hive by the Swiss beekeeper Blatt. He changed the frames for the hives. It was, the width was shortened by 40 mm, the height remained unchanged. Such frames for a hive measuring 435 mm by 300 mm were called Blatt’s, and the hives became known as the Dadan-Blatt hives. The dimensions of the multi-hull hive on the inside are 450×450 mm in width and 320-330 mm in height. The hives of Dadan-Blatt can accommodate 12 comb frames plus an insert board, if you remove it, you can install a 13 frame. During the main honey collection period, one or more stores are installed on the hive, which can accommodate 12 half-frames and can be installed, depending on the need, in half-frames along or across the main nest. The hive is equipped with a removable bottom for ease of maintenance. The principle of placing frames is presented in the form of a cold skid.

Having considered the two main types of hives, I would like to emphasize that the right choice of a hive for a particular type of beekeeping depends on convenience, both for bees and for the beekeeper and minimization of effort during work.