Discussion: Cholinergic Urticaria
Purpose
The purpose of this discussion is to apply pathophysiological concepts to a child presenting with dermatological dysfunction (urticaria). Related concepts will also be applied that includes alterations in immunity/inflammation, fluid and electrolytes, acid/base balance and pulmonary function.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Explore age-specific and developmental alterations in the dermatological system. (CO 3, 1)
Relate pathophysiological alterations in dermatological processes to the development, diagnosis and treatment of common skin disorders. (CO 4, 2)
Examine current evidence to support the management of patients who present with alterations in the dermatologic system. (CO 5, 3)
Due Date:
The student must provide an answer to the graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week.
Students must post a minimum of two times (response to peers) in the graded discussion. The two posts in the discussion must be on separate days. Posting twice on two different days meets the minimum requirement. For full credit, the student must post at least three substantive posts on three different days. In addition, students must respond to all faculty questions.
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, 11:59 p.m. MT regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
A 10% penalty will be imposed for not entering the minimum number/type of interactive dialogue posts OR not posting on the minimum required number of days. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).
Total Points Possible: 100 points
Requirements:
A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.
Discuss the likely cause of the patient’s urticaria.
Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
Describe the relationship between the patient’s symptoms and the concept of inflammation.
What pharmacological and non-pharmacologic treatment options are available?
Discuss the complications of urticaria.
What teaching would be appropriate to provide the parent and child about urticaria?
Support your response with at least one current evidence based resource
DISCUSSION CONTENT
Category
Points
%
Description
Application of Course Knowledge
30
30%
Posts make direct reference to concepts discussed in the lesson or drawn from relevant, evidence based outside sources, AND
Posts are on topic and answer all presented questions which demonstrates a solid understanding of the topic.
Applies concepts to personal experience in the professional setting and or relevant application to real life, AND
Decisions are well supported with evidence-based arguments that are in-line with the scenario; AND
Proper rationale and reasoning skills are demonstrated; AND
Information is taken from source(s) with appropriate interpretation/evaluation to develop a comprehensive analysis or synthesis of the topic
Support From Evidence Based Practice
30
30%
Discussion post is supported with appropriate, scholarly sources; AND
Sources are published within the last 5 years (unless it is the most current clinical practice guideline (CPG); AND
Reference list is provided and in-text citations match; AND
Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
Interactive Dialogue
30
30%
Student provides a substantive* response to at least two topic-related posts of a peer; AND
Evidence from appropriate scholarly sources are included; AND
Reference list is provided and in-text citations match; AND
Student responds to all direct faculty questions OR if student was not asked a direct question, student responds to either a 3rd peer post or a faculty question directed towards another student
(*) A substantive post adds new content or insights to the discussion thread and information from student’s original post is not reused in peer or faculty response
90
90%
Total CONTENT Points= 90 pts
DISCUSSION FORMAT
Category
Points
%
Description
Grammar, Syntax, Spelling, & Punctuation
10
10%
Grammar, spelling, and/or punctuation are accurate, or with zero to one error.
Direct quotes in discussions are limited to one short quotation (not to exceed 15 words). The quote adds substantively to the discussion.
(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
10
10%
Total FORMAT Points= 10 pts
DISCUSSION TOTAL=100 points
Cholinergic Urticaria
Student’s Name
Institutional Affiliation
Course
Professor
Date
Cholinergic Urticaria
Allergies are sensitive reactions when a person's immune system responds abnormally to natural substances such as dust, food, and pollen. Allergic reactions present themselves through different symptoms. Some of these symptoms make allergies hard to detect, while others are life-threatening, like urticaria. Urticaria is a skin reaction that is characterized by hives. These hives are red and itchy welts occurring as a result of a skin reaction (Mayo Clinic, 2020). Antia et al. (2018) noted that various types of urticaria common to people. They include delayed pressure urticaria (caused by pressure), cold urticaria (caused by freezing), solar urticaria (caused by exposure to the sun) cholinergic urticaria (caused by heat, stress, or exercise). In the scenario presented, the urticaria's likely cause is the movement and heat experienced after spending some time on the football field. This type of urticaria is called physical/cholinergic urticaria.
Ojeda et al. (2018) explains cholinergic urticaria to be characterized by pruritic swellings occurring when a person sweat. When a person sweats, there is histamine release that causes plasma to escape the dermis tissues, causing local vasodilation and the activation of the skin's sensory ending, resulting in painful swelling. Patients who are hypersensitive to sweat antigens tend to develop wheals as a response to the sweat substances that leaks from the dermis' syringeal ducts. The boy's symptoms included pain and swelling, resulted from the release of histamine in his body, which reacted with the skin dermis, causing hives' formation.
The relationship between patient symptoms and the inflammation concept results from an increase in vascular permeability. According to Ojeda et al. (2018), vascular permeability causes painful inflations that are itchy. The hives usually affect the papillary dermis, where they occur for a short time for about 30 minutes. Doctors, in the treatment of urticaria, apply various pharmacological and non-pharmacological therapi...