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What Causes Recurrent Allergic Itchy Red Bumps On Skin?
Question: Respected Dr SUJOY XXXXXXX (ALLERGIST / IMMUNOLOGIST)
Its a case of allergy of my younger sister aged 18 now currently staying at hostel in XXXXXXX
Last year, one night, for the first time, there was allergy with itching sensation of the whole body (leaving the face) and couldn't sleep properly. The next morning, however, it subsided and came back to normal. It did not happen for a year, until 6 days back from today. The first 5 days, till yesterday, she had allergy only in few parts of the body especially around 9 PM after having dinner and would be normal the next morning. One day, there were allergy on legs, feet and the next day on thighs, hands etc and so on. The allergy was bearable to her and because of her classes, she hasn't visited any doctor.
But today, the allergy has spread to all the parts of the body (except face) and it isn't lessening at all. She also felt quite itchy and sort of felt slight ache because of the itchiness.
She is currently staying at hostel and so, on the advice of a family acquaintance, tablet alday (10 mg) was taken yesterday night. She told me that afterwards, it subsided and has come back to normal when she woke up today morning.
Pls help Sir...What can be the problem???...I have some photographs as well which I have uploaded.
Sincere regards,
XXXXXX
Its a case of allergy of my younger sister aged 18 now currently staying at hostel in XXXXXXX
Last year, one night, for the first time, there was allergy with itching sensation of the whole body (leaving the face) and couldn't sleep properly. The next morning, however, it subsided and came back to normal. It did not happen for a year, until 6 days back from today. The first 5 days, till yesterday, she had allergy only in few parts of the body especially around 9 PM after having dinner and would be normal the next morning. One day, there were allergy on legs, feet and the next day on thighs, hands etc and so on. The allergy was bearable to her and because of her classes, she hasn't visited any doctor.
But today, the allergy has spread to all the parts of the body (except face) and it isn't lessening at all. She also felt quite itchy and sort of felt slight ache because of the itchiness.
She is currently staying at hostel and so, on the advice of a family acquaintance, tablet alday (10 mg) was taken yesterday night. She told me that afterwards, it subsided and has come back to normal when she woke up today morning.
Pls help Sir...What can be the problem???...I have some photographs as well which I have uploaded.
Sincere regards,
XXXXXX
Brief Answer:
Severe urticaria and angioedema
Detailed Answer:
Dear XXXXXXX,
Thank you for uploading the pictures that were very useful and also noted that this has been going on for some time now.
The clinical diagnosis is: Urticaria and angioedema
Urticaria is a skin condition with raised, red, itchy lumps - rather like nettle stings. It is also known as hives. The lumps can be very itchy and distressing, but are not necessarily dangerous. Each crop of skin lesions usually lasts less than a day, but fresh crops can appear one after the other. Episodes
that go on for more than six weeks are called chronic urticaria; shorter attacks are called acute urticaria. Acute urticaria is common - around 20% of the population has an episode at some time in their life.
The itching and swelling appears to be caused by histamine, a chemical found naturally in some of the defence cells of the body, called mast cells. Other naturally occurring chemicals may also be involved.
Tests recommended:
Complete hemogram
Liver function tests
Complement C3, C4 levels
TSH, Anti-TPO antibodies
Vit D3 levels
The main treatment for urticaria is therefore antihistamine medications. There are many sorts, and for unknown reasons, some suit some individuals better than others do.
Prednisolone is advised for 5 days as a relief measure and also to allow antihistamines to work.
A typical treatment that I recommend is as follows:
1. Ranitidine 300mg before food followed by Wysolone 30mg after food for 5 days
2. Fexofenadine 180mg 1 tab at 8Am after breakfast
3. Atarax (Hydroxyzine) 50mg before bed (25mg x 2 tablets)
No 2 and 3 to be continued for 6 weeks, and if 100% improvement is noticed, take only Allegra 180mg for the next 6 weeks
I would like to see the reports when available
Hope that was useful.
Severe urticaria and angioedema
Detailed Answer:
Dear XXXXXXX,
Thank you for uploading the pictures that were very useful and also noted that this has been going on for some time now.
The clinical diagnosis is: Urticaria and angioedema
Urticaria is a skin condition with raised, red, itchy lumps - rather like nettle stings. It is also known as hives. The lumps can be very itchy and distressing, but are not necessarily dangerous. Each crop of skin lesions usually lasts less than a day, but fresh crops can appear one after the other. Episodes
that go on for more than six weeks are called chronic urticaria; shorter attacks are called acute urticaria. Acute urticaria is common - around 20% of the population has an episode at some time in their life.
The itching and swelling appears to be caused by histamine, a chemical found naturally in some of the defence cells of the body, called mast cells. Other naturally occurring chemicals may also be involved.
Tests recommended:
Complete hemogram
Liver function tests
Complement C3, C4 levels
TSH, Anti-TPO antibodies
Vit D3 levels
The main treatment for urticaria is therefore antihistamine medications. There are many sorts, and for unknown reasons, some suit some individuals better than others do.
Prednisolone is advised for 5 days as a relief measure and also to allow antihistamines to work.
A typical treatment that I recommend is as follows:
1. Ranitidine 300mg before food followed by Wysolone 30mg after food for 5 days
2. Fexofenadine 180mg 1 tab at 8Am after breakfast
3. Atarax (Hydroxyzine) 50mg before bed (25mg x 2 tablets)
No 2 and 3 to be continued for 6 weeks, and if 100% improvement is noticed, take only Allegra 180mg for the next 6 weeks
I would like to see the reports when available
Hope that was useful.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Sir for your prompt reply.
My sister has told me that she has bought all the medications and will start it from tonight. Regarding the tablets Ranitidine & Wyosolone, does she have to take it twice a day i.e before lunch & dinner AND after lunch & dinner respectively (slight confusion because of the food referred). The tests as recommended by you shall be taken by tomorrow morning or the day after and will upload the same to you. However, the follow up seems to be closing in 2 days time, so how will I apprise you of the reports???
However, Sir, yesterday while narrating the incident, my sister has left some history which I am not sure about its relevance. Sir, please bear me with the story now as she has not told me yesterday about all these.
About 2 years back, she did the hair straightening in some saloon which used some chemicals for the purpose. After 3 months approx, her hair became coarse and started falling more than normal. She went to a dermatologist who prescribed some medicines for hair growth. The result was that there wasn't any significant hair growth (on the head) and instead hair growth started happening in the legs and arms.
So, she went to some other dermatologist who asked carrying out certain test which I want to upload but there seems to be no link given in the follow up process. She was told to take Multi-vitamin XXXXXXX Keraglo & Hair supplement soflet Revilus for 3 months & 5 months respectively.
Sir, only now she told me all this because the first instance of allergy which I mentioned earlier happened after few weeks of taking these 2 medicines and during her menstrual period. She had the doubt whether there was any connection between the allergy and the medication but the dermatologist clarified that it is not possible at all. Hair supplement Revilus medication was over 2 months back but she is still taking the Multi-vitamin XXXXXXX Keraglo.
Whether, all these, may have any link with the allergy she is experiencing now or there isn't any relevance. And whether there will be any change in the prescription???.
Please reply Sir.
With sincere regards,
XXXXXXX
My sister has told me that she has bought all the medications and will start it from tonight. Regarding the tablets Ranitidine & Wyosolone, does she have to take it twice a day i.e before lunch & dinner AND after lunch & dinner respectively (slight confusion because of the food referred). The tests as recommended by you shall be taken by tomorrow morning or the day after and will upload the same to you. However, the follow up seems to be closing in 2 days time, so how will I apprise you of the reports???
However, Sir, yesterday while narrating the incident, my sister has left some history which I am not sure about its relevance. Sir, please bear me with the story now as she has not told me yesterday about all these.
About 2 years back, she did the hair straightening in some saloon which used some chemicals for the purpose. After 3 months approx, her hair became coarse and started falling more than normal. She went to a dermatologist who prescribed some medicines for hair growth. The result was that there wasn't any significant hair growth (on the head) and instead hair growth started happening in the legs and arms.
So, she went to some other dermatologist who asked carrying out certain test which I want to upload but there seems to be no link given in the follow up process. She was told to take Multi-vitamin XXXXXXX Keraglo & Hair supplement soflet Revilus for 3 months & 5 months respectively.
Sir, only now she told me all this because the first instance of allergy which I mentioned earlier happened after few weeks of taking these 2 medicines and during her menstrual period. She had the doubt whether there was any connection between the allergy and the medication but the dermatologist clarified that it is not possible at all. Hair supplement Revilus medication was over 2 months back but she is still taking the Multi-vitamin XXXXXXX Keraglo.
Whether, all these, may have any link with the allergy she is experiencing now or there isn't any relevance. And whether there will be any change in the prescription???.
Please reply Sir.
With sincere regards,
XXXXXXX
Brief Answer:
No changes to prescription
Detailed Answer:
I do not think the hair loss is related to the current skin condition.
This could have been the case if the ANA was positive and the urticaria may be an autoimmune variant.
The ANA report was negative that you have uploaded.
There is no hurry to get the blood tests done now, but more important is to start taking the medications.
The Zinetac and Wysolone are only once daily.
Best Wishes.
No changes to prescription
Detailed Answer:
I do not think the hair loss is related to the current skin condition.
This could have been the case if the ANA was positive and the urticaria may be an autoimmune variant.
The ANA report was negative that you have uploaded.
There is no hurry to get the blood tests done now, but more important is to start taking the medications.
The Zinetac and Wysolone are only once daily.
Best Wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir,
1) My sister has started taking the medication as prescribed and she is feeling improved now. However, she says that she feels very sleepy despite her normal duration of sleep. She is slightly concerned about it as her final exams are around the corner. She just wanted to know whether this is due to any of the medications and if so, whether is this sleepiness going to stay for the whole 6 weeks or for some few days only?? And if the sleepiness is going to stay for a long time, is there any alternative medication for the same so that the sleepiness will slightly decrease?
2) With regards to the probable cause / reason, my sister says that everytime she had this allergy, it always coincided with her menstrual period. Also, at a time when her tension / stress are high (last time because of loss of hair & this time due to her 1st year final exams). Can there be any link or just a coincidence??
3) Apart from the medications Sir, is there any necessity to take any precautions regarding food / diet or other things??
Please reply Sir.
Once again, thank you for your help.
With sincere regards,
XXXXXXX
1) My sister has started taking the medication as prescribed and she is feeling improved now. However, she says that she feels very sleepy despite her normal duration of sleep. She is slightly concerned about it as her final exams are around the corner. She just wanted to know whether this is due to any of the medications and if so, whether is this sleepiness going to stay for the whole 6 weeks or for some few days only?? And if the sleepiness is going to stay for a long time, is there any alternative medication for the same so that the sleepiness will slightly decrease?
2) With regards to the probable cause / reason, my sister says that everytime she had this allergy, it always coincided with her menstrual period. Also, at a time when her tension / stress are high (last time because of loss of hair & this time due to her 1st year final exams). Can there be any link or just a coincidence??
3) Apart from the medications Sir, is there any necessity to take any precautions regarding food / diet or other things??
Please reply Sir.
Once again, thank you for your help.
With sincere regards,
XXXXXXX
Brief Answer:
Sleepiness due to Atarax, can lower or change
Detailed Answer:
Hello,
The sleepiness is due to the hydroxyzine and as the dose is quite high, the side effect of sleepiness is obvious.
You can ask her to lower the dose to 25mg (one tablet) and add Levocetzine 5mg
and if the sedation does not improve but without no worsening of skin condition, then stop atarax and rake 2 tabs of Levocetzine.
I do not recommend a special diet for urticaria unless there is underlying hypothyroidism when lowering cabbage and soya bean intake helps.
Stress is a known trigger for urticaria, so situations that lead to stress for extended durations does not help.
Best Wishes.
Sleepiness due to Atarax, can lower or change
Detailed Answer:
Hello,
The sleepiness is due to the hydroxyzine and as the dose is quite high, the side effect of sleepiness is obvious.
You can ask her to lower the dose to 25mg (one tablet) and add Levocetzine 5mg
and if the sedation does not improve but without no worsening of skin condition, then stop atarax and rake 2 tabs of Levocetzine.
I do not recommend a special diet for urticaria unless there is underlying hypothyroidism when lowering cabbage and soya bean intake helps.
Stress is a known trigger for urticaria, so situations that lead to stress for extended durations does not help.
Best Wishes.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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