Section 169 of Allergy
Also known as allergic hypersensitivity, is the damage to normal tissues, the immune system response. It is the same on the mechanism of function of the body similar to the normal defense, but hypersensitivity may have some body damage. Therefore, the composition of the immune system (see Section 16) the normal defense of the antibodies, lymphocytes and other cells are involved in allergic reactions, such as transfusion reactions, autoimmune diseases, organ transplant rejection.
Most people use the word allergy, refers to immunoglobulin E (IgE) antibodies in response. IgE antibody binding with specific cell, including blood circulating basophils and tissue macrophages. When IgE antibodies and antigens within these cells when combined, called allergens, may promote the release of these cells could damage surrounding tissue chemicals. Almost all substances can be allergens: dust, pollen, drugs or food, they are used as antigen to stimulate the body to produce the immune response.
Sometimes, using the term atopic disease to describe a group of hereditary IgE-mediated diseases such as allergic rhinitis and allergic asthma, they are called atopic diseases because some of these patients inhaling harmful substances such as pollen, mold, animal dander, dust mites is easy to produce IgE antibodies after. Eczema are atopic diseases, and IgE antibodies in the role of the disease in not clear (see Section 194). However, atopic patients in the injection of allergen, such as drug or insect toxin production is not increased risk of IgE antibodies.
Uneven performance of allergy, most people just tears increased, eye itching, or sneezing, severe, there may be difficulty in breathing, heart failure, low blood pressure, leading to life-threatening shock. This type of reaction often referred to as allergic reactions, allergies may occur in response to different situations, such as eating certain foods, taking a drug or bee stings shortly after onset.
】 【Diagnosis
Due to allergy multi-induction by some allergen, so the key is to determine the diagnosis of allergen. Allergens may be seasonal plants or their products, such as grass or pollen; may be other substances such as cat dander, drugs or food. The allergen contact with the skin, into the eyes, is inhaled, ingested or injected into the body can cause allergic reactions after. Carefully by doctors and patients often find the allergen can be found.
Relevant inspection can determine whether the allergy symptoms can be determined according to the relevant allergen. Blood tests can be found eosinophilia, these cells are a kind of white blood cells, often when the increase in allergy. Allergen with a radioactive assay (RAST) (referred to as RIA) detection of certain allergens in IgE antibody levels to help diagnose skin allergy, seasonal allergic rhinitis or allergic asthma.
Skin test for identification of specific allergen useful. Is: a small amount from the trees, grass, pollen, animal dander, insect toxins, food, or certain drugs diluted extracts were injected into the test by the skin. If one of these substances in one or more allergies, in a solution of 15 to 20 minutes after injection of the injection site edema within groups like the wind (the wind around the flushing group like mass.) RIA can be used in skin test or can not be unsafe in patients with skin test, both methods have high specificity and accuracy, while the skin test the accuracy of the higher, and less expensive, can quickly know the result.
【Treatment】
Avoid contact with allergens is more important than the treatment of allergy. Avoid contact with allergens causing allergic drug should be discontinued; installation of air conditioners with filters; the pets in the house; do not eat the food allergies; allergic to the work environment should be a job change. Seasonal changes should reflect the serious people should move to allergen-free areas.
Other measures include reducing exposure to allergens, such as dust allergies, can not easily dust the furniture, carpets and curtains; mattress pads and pillows covered with plastic film; to clean the house and mopping the floors; Air Conditioner reduce indoor humidity to the growth of dust mites is not easy; installation of high efficiency air filters.
Some allergens, in particular allergen in the air is hard to avoid, doctors can block allergic reactions in some ways, also available drugs alleviate the symptoms.
Allergen desensitization therapy
When a time is difficult to avoid allergens, allergen desensitization therapy (desensitization injections) be regarded as a treatment option. Method: begin with small doses of allergen injected into the skin, and then gradually increase the dose to maintenance dose. The ways to stimulate the body to produce closed to prevent allergy or neutralizing antibodies. Eventually, the blood IgE antibody titer decreased after antigen binding. Desensitization therapy should be cautious, because exposure to high levels of allergens in itself will produce allergic too.
While many people have experienced desensitization therapy, but studies have shown that its role, the cost - benefit ratio and dangerous - better than not satisfactory, for some people, certain allergies and effective, while others may be poor. This treatment commonly used in those pollen, dust mites, animal dander, insect toxins and allergies, while those of food allergies is usually not recommended because of the risk of allergic reactions.
Such as to adhere to continuous injection of the best. Beginning of treatment, weekly injections 1 and gradually increased to maintenance dose, and then transition to the injection of 4 to 6 weeks 1.
Because desensitization can occur after injection adverse reactions, generally require patients to observe the injection of at least 20 minutes, where there is sneezing, coughing, skin flushing, tingling, itching, gas tight, asthma or urticaria, the tips are allergic occurred, such as mild symptoms may be given antihistamines such as diphenhydramine, chlorpromazine to control symptoms; serious reactions are required injection of adrenaline.
Antihistamines
Antihistamine commonly used to treat allergy medication (not for asthma). There are two kinds of histamine receptors in vivo: histamine 1 (H1) and histamine 2 (H2). Commonly referred to as H1 receptor antihistamines is closed to the drug, the receptors are stimulated by histamine can result in target tissue damage. H1 and H2 can not be confused with the two receptor antagonists, H2 receptor antagonist treatment of duodenal ulcer and acid reflux key.
Many minor allergy symptoms such as itching, runny nose and itchy skin are caused by histamine release. Histamine caused by the more serious symptoms: shortness of breath, hypotension, laryngeal edema due to airway obstruction.
The role of all antihistamines are similar, and their side effects are quite different. Response after treatment with the drugs used in different types and different patients, such as some antihistamines have strong sedative effect, others are not, and the sensitivity of this effect is different. Sometimes used to treat side effects of drugs, such as certain antihistamines have anticholinergic effects, can cause mucosal drying, this side effect can be used to treat runny nose caused by colds.
Some non-prescription antihistamines, with short-acting, but also release agent, which can be used in conjunction with a vasoconstrictor to relieve nasal congestion (see Section 13). Other antihistamines require a prescription and used under medical supervision.
Most antihistamines cause drowsiness, it is because they have a strong sedative effect, these drugs often non-active ingredients of prescription sleeping pills. Most antihistamines have strong anticholinergic effects, may cause confusion, dizziness, dry mouth, constipation, difficulty urinating, blurred vision, especially the elderly prone (see Section 9), but most adverse reactions will not occur, so you can use the price of sleepiness than the role of non-prescription anti-histamine is much cheaper than the non-prescription drugs. In order to reduce the drowsiness and other side effects of antihistamines without affecting the efficacy of medication usually start small dose and gradually increase to the effective dose. At present, a variety of non-drowsiness and anticholinergic side effects of antihistamines available, including: astemizole, cetirizine, loratadine and terfenadine.
The type of allergy
Allergy is generally based on the cause, affected body parts and other features for classification.
Allergic rhinitis is a common type of allergy, it is a certain air of particles such as pollen and grass allergies caused by particles, as well as mold, dust and animal dander, etc., expressed as sneezing, nasal itching, flow tears, nasal congestion, itching and eye irritation and other symptoms. Allergic rhinitis can be seasonal, or non-seasonal (perennial).
Seasonal allergic rhinitis
Seasonal allergic rhinitis is allergic to airborne pollen, usually hay fever or hay fever.
In the United States in different places, different plant pollen season. In the eastern, southern and Midwest in the spring, hay fever caused by the plants in spring is often oak, elm, maple, alder, birch, juniper and olive; in the early summer, mainly grass, such as grass, small bran grass The new shoots and fruit trees; in late summer, is the number of weeds. In the West, pollinating flowers and a longer time, other weeds may also cause hay fever. Occasionally, seasonal allergic rhinitis caused by mold spores.
】 【Symptoms and diagnosis
When pollination season, nasal, mouth, throat and eyes and other parts will be gradual or sudden itching, followed by tears, sneezing, runny nose. Some headache, cough, asthma; restlessness, irritability, depression, loss of appetite and insomnia. There conjunctivitis, nasal irritation caused by nasal congestion, runny nose.
More difficult to diagnose seasonal allergic rhinitis. Skin test and medical history help to identify allergenic pollen.
【Treatment】
Antihistamines are the first choice for the treatment of seasonal allergic rhinitis drug. Sometimes combined with some decongestants, such as ephedrine, pseudo ephedrine hydrochloride to reduce nasal congestion, runny nose; but with hypertension of patients, unless under medical supervision in general do not have this type of decongestant.
Cromolyn sodium nasal spray can also be treated. It is a prescription drug, the price is expensive than antihistamines, commonly used in the local lesion, such as the back of the nose and pharynx. If antihistamines and cromolyn sodium can not control the symptoms, you need to use prescription steroid sprays, the drug has significant effect, almost no side effects. If the above measures are ineffective, should be short (no more than 10 days) of oral corticosteroids to control severe symptoms.
For patients with drug-induced serious side effects, often have oral corticosteroids in the development of asthma patients or patients should be desensitization treatment, a series of allergy desensitization injections to prevent the onset of symptoms (see section 13). Desensitization treatment of seasonal allergic rhinitis should be a few months before the pollination season begins.
Perennial allergic rhinitis
Perennial allergic rhinitis (PAR) of the symptoms of seasonal allergic rhinitis were similar, but symptoms of perennial allergic rhinitis light when the heavy, difficult to predict, can occur in any season.
Allergen of the disease may be dust mites, feathers, animal dander or mold. Clinical manifestations of conjunctivitis is not common, often stuffy nose, causing eustachian tube obstruction, resulting in hearing loss, especially in children. Identification and sinusitis and nasal polyps should be (see Section 213). Sinusitis and nasal polyps may be complications of allergic rhinitis.
Certain chronic rhinitis, sinusitis, nasal polyps in patients with allergen skin test was negative, a large number of eosinophils in nasal secretions, these people with aspirin and other nonsteroidal anti-inflammatory drugs are susceptible to severe reactions. Difficult to treat these people is a serious asthma attack, the performance of this adverse reaction. Such a reaction should avoid the use of non-steroidal anti-inflammatory drugs.
Chronic nasal congestion, runny nose but no sinusitis, nasal polyps or other causes of allergies may suffer from varying degrees of atrophic rhinitis, it is not caused by the allergic reaction (see Section 213).
【Treatment】
If can find specific allergen, the treatment of perennial allergic rhinitis and seasonal rhinitis is very similar. Although not in favor of oral corticosteroids, but corticosteroid nasal spray is very effective. Non-prescription decongestant nose drops or sprays should not exceed a few days to use as more than a week will cause a rebound effect, so that aggravated or persistent nasal inflammation. Nasal polyps and sinusitis sometimes require surgery.
Allergic conjunctivitis
Allergic conjunctivitis is inflammation of the conjunctiva allergy. Conjunctiva that covers the inside of the eyelids and ocular surface layer of fine film.
Most people allergic conjunctivitis is a part of allergy syndrome, such as seasonal allergic rhinitis. However, there may also be separate components such as with air-borne pollen, mold spores, dust or animal dander direct contact with people. Onset of conjunctival edema, itchy eyes, a lot of tears.
Certain drugs, cosmetics (such as eye shadow, foundation) or after chemical into the eyes can cause allergic reactions, it often involving the skin around the eyes, is a contact dermatitis.
【Treatment】
The main treatment for allergic conjunctivitis is an oral antihistamine, antihistamines can also be together with a vasoconstrictor eye drops to reduce congestion. Sometimes antihistamines itself or other substances in solution can aggravate allergies, so the general idea of oral administration. If the estimated exposure to allergens the patient may be used to prevent allergic reactions to cromolyn sodium eye drops. Corticosteroid eye drops can be used for more serious cases, but can cause some complications such as glaucoma. Corticosteroid eye drops used during the intraocular pressure should be measured regularly.
Wash with a small irritant agents such as artificial tears wash the eyes, reduce eye irritation. Avoid substances can cause allergic reactions. During the onset should stop wearing contact lenses. When these therapies can not get satisfactory results, we recommend use of desensitization therapy.
Food allergy and intolerance
Food allergy is an allergic reaction occurred in a particular food. In most cases ill after eating a certain food, no allergic reactions, are on food intolerance.
Many non-food allergies due to various causes, a certain food intolerance, for example, some people lack the enzymes to digest certain foods. If digestive intolerance to certain foods, there will be indigestion, flatulence, nausea, diarrhea or other problems. Allergic reactions usually do not have such symptoms. There are many so-called food allergy controversial claims, such as the children's hyperactivity caused by chronic fatigue and arthritis, poor sports performance, depression and so attributed to food allergy is unfounded.
【Symptoms】
Food allergy is common in infancy, especially in a atopic diseases (such as allergic rhinitis or allergic asthma) a family history of babies. Initial performance may be eczema. Eczema may be associated with or without nausea, vomiting, diarrhea and other gastrointestinal symptoms, which may or may not be caused by food allergies, eczema to 1 year old may have been not a major problem. Children have food allergies, with age, there may occur other atopic diseases, including allergic asthma and seasonal allergic rhinitis. However, adults and children over 10 years of age, even if the skin test was positive relationship between food allergy and respiratory symptoms is not.
Some of the special food allergens, particularly nuts, beans, seeds and shellfish can be severe allergic reactions. Of these people even though consumption of food allergy may also occur extremely small amount of the reaction, expressed as body rash, laryngeal edema and obstruction and breathing difficulties. A sudden drop in blood pressure, leading to syncope and collapse. This is called acute life-threatening allergies. Some people only eat the food allergic reactions appear immediately after exercise.
Food additives can cause food allergy or intolerance symptoms. Certain foods contain toxins or chemical substances (eg histamine), which can cause non-allergic adverse reactions, such as monosodium glutamate (MSG) does not cause allergic reactions. There are reports of sulfate (as a food preservative, such as the focus of sulfite) and dyes (such as tartrazine, a yellow dye can be used for candy, soft drinks and commercially prepared food) sensitive person, after exposure to such substances causing asthma and urticaria. Others, after eating certain foods can cause migraines.
Food allergy and intolerance symptoms are usually very clear, but that the strict distinction between the two is not easy. Some adults for many oral intake of allergens through the digestive prevent allergic reactions. For example, asthma baker baker at work due to inhalation of dust caused by flour or other grains, but he does not eat the food allergies.
】 【Diagnosis
Skin test can help diagnose food allergies; positive skin test result does not mean that a food allergy of some sort; negative is unlikely to have food allergies. If the positive results of oral provocation test should be further for the upcoming suspected food hidden in the carrier food such as milk or apple sauce in the food to the subjects. If symptoms do not occur, indicating that not allergic to that food. The best single-blind challenge test method, the carrier to the subjects to eat foods with or without suspicious food, which is more helpful to determine whether its true allergy.
Exclusion diet can help identify cause of allergies. Subjects to stop eating may cause symptoms of food, after eating a food from time to time. Doctors to develop recipes, must be strictly observed, the use of pure products. To achieve these requirements is not easy, because many food ingredients in other foods such as wheat flour, rye bread often. In addition to doctor's recipe, but can not eat other foods and beverages. Not in favor of the restaurant dining, because the subjects (and doctors) must know each meal to eat all the food ingredients.
【Treatment】
In addition to stop eating the food allergies, there is no specific effective treatment, especially those severe allergic reaction after eating, such as skin rashes, mouth and laryngeal edema or shortness of breath patients should avoid contact with food allergies.
With a small amount of food or food extract under the tongue of the desensitization therapy droplets not ideal. Prevention of food allergy with antihistamines practicality is not high, but the acute allergic reactions such as urticaria or angioedema who have a certain effect.
Allergic reactions
Allergic reaction is an acute, systemic, severe to even life-threatening allergy, some in patients previously sensitized allergen exposure to the same allergen again occurs when.
Allergic reactions caused by various allergens, the most common are drugs, insect bites, certain foods, or desensitization injections. First contact with the allergen does not occur when the allergic reaction. For example, the initial contact with penicillin or bee stings does not produce allergic reactions, and exposure may occur again. But most people do not know when the first contact with a certain allergen.
When the allergen into the blood reacts with the IgE class of antibodies produced after the beginning of an allergic reaction. This response stimulated cells to release histamine and other substances involved in immune inflammatory response, followed, pulmonary bronchoconstriction, causing difficulty in breathing; vascular dilation caused by decreased blood pressure; increased vascular permeability, causing exudate, edema, and urticaria; cardiac dysfunction, arrhythmia and cardiac output is inadequate; the final cause shock (see Section 24).
Anaphylactoid-like reaction with an allergic reaction similar to, but can occur after the initial injection of certain drugs (such as polymyxin, some of the contrast agent.) It is not IgE antibodies in the pathogenesis, therefore, does not belong to allergic reactions. Some people, especially those of perennial allergic rhinitis and nasal polyps may be due to aspirin and other nonsteroidal anti-inflammatory drugs cause anaphylactoid-like reaction.
【Symptoms】
Symptoms of allergic reaction to allergens in contact with immediately or within 2 hours after emergence. The patient feels discomfort, irritability, palpitations, trembling, flushing of skin itching, ringing in the ears, coughing, sneezing, urticaria, edema, or airway obstruction caused by asthma and breathing difficulties, can not appear in the case of respiratory symptoms cardiovascular system failure. Usually an allergic reaction may occur in the event of cardiovascular or respiratory symptoms, but symptoms of the two systems are not simultaneous, multiple allergic reactions of people, each attack symptoms are often similar. Allergic reaction process is very fast, can quickly lead to collapse, convulsions, incontinence, loss of consciousness, 1 to 2 minutes of stroke. Unless immediate emergency treatment, or allergic reactions often lead to death.
【Prevention】
Bee stings are allergic reaction occurred after a history of people, stung again after the same reaction will occur. Other allergens, such as drugs, also the same. General medicine before the skin test every time is unrealistic, however, animal serum (eg, taken from Martinique, tetanus antitoxin) or a history of penicillin allergy, the use of these drugs should be made before the skin test.
Can not be avoided for some people allergic to allergens such as insect sting allergies long-term desensitization treatment can prevent allergic reactions. Desensitization therapy is not used to avoid contact with allergens, such as penicillin or other drugs. If you must use some drugs (such as penicillin or prepared from horse serum antitoxin), the diagnosis should be under intensive care room or hospital for rapid desensitization.
Some people on the X-ray contrast agents used in some of the history of allergy. Doctors should try to avoid using this contrast agent, but must be used, can be difficult to cause the reaction of special contrast agents. In addition, the use of contrast agent may be able to block the allergic reaction before taking the drugs, such as prednisone, diphenhydramine, ephedrine.
【Treatment】
Treatment of choice for anaphylaxis is epinephrine injection. After insect stings are allergic or allergic to certain foods, especially allergic reactions and shock people, should always bring their own syringes and epinephrine, to prepare for emergency use.
Can be blocked by the above method is usually an allergic reaction, allergic reactions, but all people should be sent to the hospital as soon as possible, because of the need intensive care cardiovascular and respiratory systems, and may prompt further treatment.
Urticaria
Urticaria (hives) that appear in the skin of the small, pale or red swelling plaques.
And urticaria related, sometimes it also occurs as a symptom of blood vessels (nerves), edema, which appears larger and deeper involvement of the subcutaneous tissue. Both are a type of allergic reaction, confined to the skin and subcutaneous tissue. Cause may be related to allergens, drug-related or of unknown etiology. Common variable should be the original: drugs, insect stings or bites, desensitization injections and certain foods, especially eggs, oysters, nuts and fruit. Sometimes eat small amounts of food will be immediately urticaria, sometimes eating a certain food in a large number (such as strawberries) later. Urticaria can also be infected, such as hepatitis, infectious mononucleosis and rubella syndrome after.
Repeated attacks over several weeks or months of urticaria is difficult to clear cause; sometimes never find special reasons, and occasionally long-term use of certain unconscious food additives, drugs or other chemicals might be involved. For example, preservatives, dyes and other food additives, a very small amount of penicillin in milk (treatment cow disease) and certain non-prescription drugs. A small number of chronic diseases (such as systemic lupus erythematosus, polycythemia vera, lymphoma, hyperthyroidism, or infection) and urticaria simultaneous. Although psychological factors suspected, but not confirmed.
Certain drugs such as aspirin can aggravate symptoms of urticaria. Urticaria caused by the aspirin in patients with other non-steroidal anti-inflammatory drugs such as ibuprofen or tartrazine (a food or drug dye) also appear similar to the response. Not associated with urticaria, angioedema may be a known as hereditary angioedema disease.
】 【Symptoms and diagnosis
Itching, urticaria is often the first symptoms, followed in the skin smooth, convex than the surrounding skin, redness or paleness of the wind group, usually small (<12mm). When the wind head of the large (up to 20cm), in the central area of the rash may fade it a ring. Urticaria wheal can suddenly and abruptly fade, appear at a particular subsided after a few hours, and then and maybe in other places.
Vascular edema, the edema may be larger depth of subcutaneous tissue, sometimes involving the hands, feet, eyelids, lips or genitals, or even the mouth, throat, airway mucosa, causing breathing difficulties.
If the hives appear and quickly disappear very quickly, no relapse, do not have to go to hospital. In addition to apparently caused by some factors, but is difficult to find out why. However, if unexplained angioedema or recurrent urticaria, it should be to the hospital.
【Treatment】
Some sudden urticaria often not treated within minutes in a few days or even disappear. If the cause is unknown, patients of all non-essential drugs should be discontinued until the symptoms disappear. Antihistamines such as diphenhydramine or hydroxyzine Ramin chlorobenzene can relieve the itching and reduce swelling. Of very severe itching and swelling may take a few days of prednisone.
If there is collapse, swallowing or breathing difficulties have to be for emergency treatment. While the use of antihistamines as soon as possible injection of adrenaline. The best treatment in hospital emergency rooms in order to closely monitor patients and adjust treatment.
Antihistamine used to relieve symptoms of chronic urticaria. Anxiolytics doxepin effective for some adult patients. If other treatment fails, use of prednisone, the long-term use of prednisone may cause many side effects, so the medication should be as short as possible time, usually no more than 3 to 4 weeks. Nearly half of the treatment of chronic urticaria can not go away within 2 years. Control your nervousness and helps to reduce the frequency and severity of disease.
Hereditary blood vessels (nerve) edema
Hereditary blood vessels (nerves) of the edema is a complement and blood 1 (C1) inhibitor lack of genetic disease.
Cl inhibitor is a component of the complement system, complement is involved in immune and allergic reactions of a group of proteins. Cl inhibitor deficiency or decrease in activity can cause local skin or subcutaneous tissue edema, can also lead to mucous membranes (mouth, throat, digestive tract) in edema. Trauma and viral disease often led attack, emotional stress can also aggravate their condition. A typical attack of edema with pain rather than itching, not associated with urticaria. Many patients have nausea, vomiting and gastrointestinal spasm, the most serious complication was upper respiratory tract edema, can cause breathing difficulties. Detection of Cl inhibitor in the blood levels and activity can be confirmed.
【Treatment】
Aminocaproic acid is sometimes used to terminate the disease onset. It may also be used epinephrine, antihistamines and corticosteroids, but not yet confirmed the efficacy of these drugs. If patients with acute attack of airway obstruction soon, should be immediately given to tracheal intubation.
Some treatment can prevent the onset of the disease, for example, suffering from hereditary angioedema in carrying out minor surgery or dental treatment to increase the input of fresh blood plasma levels of Cl inhibitor. You can also use purified Cl inhibitor to prevent the onset of the disease, but this method is not yet universal. For long-term prevention, may be oral synthetic steroid hormones (androgens), such as stanozolol or danazol to help stimulate the body to produce Cl inhibitor. Because these drugs have side effects masculine, so women patients should be careful to take the dose and close monitoring.
Mastocytosis
Mastocytosis is due to the accumulation of mast cells in the skin, and sometimes other parts of the body caused by the accumulation of the disease. Mast cells produce histamine in a cell immune response.
Mastocytosis is the most common type common type, it is often limited to the skin, especially children, also can affect other organs such as stomach, intestine, liver, spleen, lymph nodes and bone. The type of the disease is rare and some serious blood disease (such as acute leukemia, lymphoma, chronic neutropenia or myeloproliferative disorders), or with some serious disease (mast cell leukemia, recurrent urticaria coloring) related. 90% of the common type and other types of less than 50% of patients with mastocytosis urticaria pigmentosa, it is a small, red-brown small spots distributed in the body, rubbing or scratching the hives often appear and skin flushing.
Unknown etiology mastocytosis, mast cells in a few years more and more the symptoms gradually worsened, but after drug treatment can control symptoms for many years. Some patients with joint and bone pain, which suggests there may have serious allergic reaction, including symptoms similar to allergic reactions. May also occur in patients with gastric ulcer and chronic diarrhea, which is excessive because the stomach caused by histamine.
【Treatment】
The treatment of mastocytosis requires two antihistamines: H1 receptor antagonist for the treatment of allergy; H2 receptor antagonist for the treatment of stomach ulcers. If the disease associated with certain serious diseases, the treatment more complicated.
Physical allergy
Physical allergy is due to some physical stimulus, such as cold, sunlight, heat, or minor injuries caused by allergy symptoms.
Skin itching, rash, and urticaria are the most common symptoms of this disease, and sometimes breathing difficulties. Reaction is too strong of sunlight (photosensitivity) can cause hives and rashes are not common (see Section 205). Photosensitivity can be a result of taking certain medications or certain substances induce skin smear.
Particularly sensitive to heat may occur called cholinergic urticaria, is a small, itching, and wind groups independent of each other, surrounded by a circle flush. Cholinergic urticaria can appear in the movement, emotional stress or other causes sweating after the event. People particularly sensitive to cold, exposure can occur in the cold urticaria, edema, asthma, or runny nose, nasal congestion and so on.
【Treatment】
The best of physical allergy treatment is to avoid any factors that can cause allergies. Symptomatic patients should stop using cosmetics, creams, lotions and skin care oil for some time to see if these substances increase due to allergy. Antihistamines such as diphenhydramine, cyproheptadine, or hydroxyzine can ease itching. Cyproheptadine urticaria due to cold best, and hydroxyzine on the emotional tension is caused by urticaria best. People who are allergic to sunlight sunscreens should be used to reduce sunlight exposure.
Sports allergic
Some people exercise can cause asthma or acute allergic reactions.
Movement is exercise-induced asthma, a type of abnormal allergic reactions. Exercise-induced asthma can often occur in old people with asthma may also occur in people who no such history. In strenuous exercise 5 to 10 minutes after his tight chest feeling, while wheezing, difficulty breathing, the typical onset is after the motion stops. Cold and dry in the air more easily disease.
Rare is exercise-induced allergic reactions can occur in strenuous exercise. Some people just before exercise after eating a particular food only occur.
【Treatment】
The purpose of exercise-induced asthma therapy is to enable patients to exercise without symptoms. 15 minutes before exercise inhaled  -adrenergic drugs may be effective. For some people cromoglycate effective in the past history of asthma in patients with asthma, the usual method of prevention can prevent exercise-induced asthma attacks (see Section 37).
To have a history of exercise-induced allergic patients should avoid sports and known to elicit symptoms of food. Sometimes gradually increase the amount of exercise and increase exercise duration on exercise tolerance. Patients should carry syringes and epinephrine, so that timely emergency treatment.