Annoying painful swellings due to pressure-dependent hives

Doctors can help sufferers to lead a normal life again
One of the patients in the Department of Dermatology and Venereology at the University Medical Center Freiburg has been suffering from painful swellings on the thighs, forearms and buttocks for a year. The palm-sized and sometimes very painful swellings consistently itched very strongly. The affected patient always had the urge to scratch the swollen areas. Sometimes small blisters formed on the swelling. The man had already visited several other doctors without success before visiting the Freiburg University Hospital.

At a certain point, the swelling started to hurt so much that the affected person could no longer sit for a long time. For this reason, he has been on sick leave for several months. The patient usually worked in an office job. It has already been considered whether the man now 50 years old should not retire early. Of course, this consideration put additional strain on the patient, explain the experts at the Freiburg University Hospital in a press release.

Antibiotic therapy was unsuccessful
At first, the doctors tried to treat a possible bacterial infection with antibiotic therapy. However, this type of treatment was unsuccessful. The experts also observed that wheals sometimes formed on the patient's skin. These resembled mosquito bites in appearance. The wheals gave the medical doctors reason to hope. Could there be a connection between the appearance of large swellings and the selective skin elevations?

Wheals are a typical sign of hives
The patient was examined in the Department of Allergology Outpatient at the Dermatological Clinic. There the doctors could find that the wheals were a typical sign of a so-called urticaria. This disease is also known as hives, explains Dr. Sabine Müller is the senior physician at the Department of Dermatology and Venereology at the Freiburg University Hospital. However, the vesicles for the disease did not seem to fit the picture properly, the doctor adds.

What is hives?
The so-called hives are one of the most common skin diseases. About one in four people will develop this skin disease at least once at some point in their lives. Nevertheless, causal treatment is usually difficult. Unfortunately, the causes of hives are very difficult to determine. Symptoms of the disease include, for example, rashes, wheals and itching.

Causes of hives
The causes of hives can have many different reasons. An intolerance to food additives, a bacterial or a viral infection can be reasons for the disease. The authors also explain that physical stimuli such as pressure, cold and light can cause hives.

Messenger histamine triggers swelling and itching
All of these factors then cause mast cells in the skin to release the so-called messenger histamine. The messenger substance then causes a strong itch and an expansion of the blood vessels occurs. This can lead to swelling and reddening of the skin, the experts explain.

Swelling of the patient when pressed against the skine
However, the case of the sick person was completely different in one factor from typical hives. During the examination, the patient had told the doctors that the swelling became particularly bad and painful when the patient had been sitting at the desk for a long time. This enabled the doctors to see that swelling occurred where there was pressure on the skin.

Doctors use a weight to test the effect of pressure on the skin
The doctors at the University Medical Center Freiburg then began to hang a ten kilogram weight over the patient's shoulder for a period of ten minutes. After that, the doctors took the weight off again and examined the skin for swellings for several hours.

Extremely delayed pressure-dependent hives
Nothing was observed for a very long time. But six hours after the weight load, the typical swelling developed. These looked exactly like the swellings that appeared on the arms, legs and buttocks, explains Dr. Müller. This proved that it was a delayed pressure-dependent hives. The vesicles that appeared were apparently the result of a pronounced swelling with extremely severe hives, adds Dr. Müller added.

After all, doctors use antibody therapy
After this knowledge, the doctors started the usual therapy for so-called pressure urticaria. However, there was no real success with this treatment method. At this point, the patient's spontaneous hives increased and his wheals increased, the authors say. In fact, this development of the disease meant something like luck in misfortune for the sick. It has now been possible for medical professionals to use a treatment that is not normally approved for pressure hives. This antibody therapy can prevent the mast cells from being activated too strongly and thus cause hives, the doctors explain.

Antibody therapy quickly shows success
The treatment quickly shows success. After a week, the patient was completely free of health problems. Unfortunately, the disease has not been completely defeated. The sick person has to inject antibodies under his skin every four weeks, otherwise the disease returns, according to the Freiburg University Clinic.

The patient can work again and lead a completely normal life
The affected patient can live well with this minor limitation. It is now possible for him to practice his profession again and the man has even made several long-distance trips, explain the doctors. Due to the new type of treatment, the disease could no longer prevent those affected from living a normal life in our society. (as)

Author and source information

Video: Living with Chronic Urticaria - My First Flareup + Qu0026A. Autoimmune Chronic Hives. Chronic Illness (January 2022).