Chronic hives, medically known as chronic urticaria, are a skin condition characterized by itchy welts, or wheals, on the body. While often benign, these persistent skin reactions can rarely signal an underlying medical condition, including certain types of cancer.
What Are Chronic Hives?
Chronic hives involve recurrent episodes of itchy, raised welts that appear on the skin for six weeks or longer, or that recur over an extended period. Each individual welt typically appears suddenly and usually fades within 24 hours, though new ones can form as others disappear. The condition is termed “chronic” when these welts occur most days of the week for at least six weeks.
The general causes of chronic hives are varied, and in many cases, a specific trigger is never identified, a condition known as chronic idiopathic urticaria. Common factors can include autoimmune conditions where the immune system mistakenly attacks healthy cells, certain infections, or physical triggers such as pressure, temperature changes, or even exercise. Allergies are a less common cause of chronic hives compared to acute hives.
The Connection Between Chronic Hives and Cancer
A direct link between chronic hives and cancer is uncommon, yet it does exist in some situations. When cancer is involved, the hives may be a manifestation of a paraneoplastic syndrome. These syndromes are rare disorders that arise when the immune system, in its fight against cancer cells, mistakenly attacks normal cells in other parts of the body, leading to various symptoms, including skin conditions.
The body’s immune response to the malignancy can trigger the release of chemicals like histamine, causing hives. These paraneoplastic hives can sometimes precede a cancer diagnosis by several months. However, chronic hives are far more often caused by other factors.
Cancers Linked to Chronic Hives
While the connection is rare, certain types of cancer have been associated with chronic hives, primarily through paraneoplastic mechanisms. Hematological malignancies, which are cancers affecting the blood, bone marrow, and lymph nodes, are the most frequently reported types. These include lymphomas, such as Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, as well as leukemias and myelodysplastic syndromes.
Beyond blood cancers, solid tumors have also been linked to chronic hives, though less frequently. These can include cancers of the lung, particularly lung adenocarcinoma, and those of the gastrointestinal system, such as colorectal and stomach cancers. Other reported associations, though rarer, involve cancers of the kidney, breast, and thyroid. In some cases, the hives may resolve after the underlying malignancy is treated.
Identifying Concerning Hive Characteristics
Certain characteristics of chronic hives can serve as “red flags” that might prompt a more thorough investigation for an underlying malignancy. These include:
Atypical appearance, such as purpuric (bruise-like), hemorrhagic (bleeding), or bullous (blistering) hives.
Hives that are localized to a specific area and persist without moving or fading, or those that are unusually painful rather than itchy.
The presence of systemic symptoms, such as unexplained weight loss, persistent fever, drenching night sweats, swollen lymph nodes, or profound, unexplained fatigue.
Hives that are resistant to standard treatments, such as antihistamines.
Seeking Medical Guidance
Consulting a healthcare professional is important if you experience chronic hives. A doctor will conduct a medical history and physical examination to understand the nature of your hives and any accompanying symptoms.
Depending on the findings, further diagnostic tests may be necessary to identify the cause of the hives and to rule out any serious underlying conditions. These tests can include blood work to check for signs of inflammation, infection, or autoimmune markers, and in some instances, imaging studies may be considered. A thorough medical evaluation ensures proper diagnosis and management.