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Hives or the medical term urticaria are recognizable as itchy, irregular shaped, raised, red wheals that appear in different places over time. Unlike eczema or dermatitis, the rash rarely stays in one place for more than twenty four hours. Hives form as the reslut of fluid leaking from blood vessels.  When this process  occurs in  deep tissue, it is called angioedema. Hives and angioedema can be precipitated by food or drug allergy or viral infections. When hives last longer than six weeks, they are considered chronic. Most people will have remission within six to twelve months but a few may persist for several years.  Some people with angioedema have inherited the inability to produce a protein known as C1 esterase inhibitor. These patients usually have an affected parent.

There are some diseases, such as tumors of the immune system, that can lead to acquired deficiencies of C1 esterase inhibitor. Chronic hives are frequently related to an autoimmune disorder but in  the majority the cause is never identified. Autoimmunity  means that your immune system, whose purpose is to fight infection, mistakenly attacks the skin as if it were a foreign invader. Hives that are related to autoimmunity are frequently associated with thyroid problems and sometime Lupus or Rheumatoid arthritis.

Diagnosis may require testing for food or environmental allergies as well as examination of the blood for autoantibodies against the thyroid gland or nucleus of the cell. No commercially available tests are able to measure the antibodies that cause hives. Treatment begins with a combination of antihistamines, but may also require other types of medications as well . New information indicates some types of hives can be considered to be an auto-inflammatory disorder. Xolair, a drug designed to  treat severe asthma is showing promising results in people with chronic hives.