Ürtiker ve Anjioödem
Özet
Ürtiker ve anjioödem, farklı etiyolojik ve patofizyolojik mekanizmalarla ortaya çıkabilen, klinik pratikte sık karşılaşılan hastalıklardır. Ürtiker; geçici, kaşıntılı, eritemli ve ödemli papül veya plaklarla karakterizedir ve hastalığın süresi ile tetikleyici özelliklerine göre akut, kronik spontan ve kronik uyarılabilir formlara ayrılır. Patogenezde mast hücre aktivasyonu ve mediyatör salınımı temel rol oynarken, enfeksiyonlar, ilaçlar, gıdalar, fiziksel uyaranlar ve çeşitli sistemik hastalıklar tetikleyici olabilir. Ürtiker tanısı çoğunlukla kliniktir; ayrıntılı anamnez ve dermatolojik muayene temel değerlendirme yöntemleridir. Özellikle ürtikeryal vaskülit, otoinflamatuvar hastalıklar ve diğer ürtiker benzeri dermatozlar ayırıcı tanıda dikkate alınmalıdır. Tedavide tetikleyicilerin uzaklaştırılması ve semptom kontrolü esastır; ikinci kuşak H1-antihistaminikler ilk basamak tedaviyi oluştururken, dirençli kronik olgularda omalizumab ve siklosporin gibi ileri tedaviler kullanılabilir. Anjioödem, daha derin dermal, subkutan veya submukozal dokuların ödemi ile karakterizedir. Özellikle larinks tutulumu yaşamı tehdit edebileceğinden, hava yolu değerlendirmesi ve gerektiğinde acil tedavi önceliklidir.
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