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Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea?

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Dermatologist
Practicing since : 2003
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Hello,

I woke up the two days ago with blotches on my face. I went out to a concert and had a few beers and it was quite hot out while tailgating. The next morning, I woke up with a swollen parts of my face and some more blotches and VERY itchy. Today my face is sore and still itchy but not as blotchy or swollen. A doctor once told me that I may have rosacea because I have some blotchiness on my face. Can't cholinergic urticaria cause redness and blotchiness on face?

Some background: I get rashes from my own sweat and from hot showers. I have some permanent blotchiness on my face. I also suffer from dermographism urticaria and possibly cholinergic urticaria.

Anyway, Does this look like hives? Thanks
Posted Fri, 17 Aug 2012 in Skin Hair and Nails
 
 
Answered by Dr. Rohit Batra 14 hours later

Dear Patient,
Thanks for your query.
Allergy, Hives and Urticaria are manifestations of the same spectrum and hence if you develop one it means that you are prone to allergies and can develop any of the symptoms mentioned.
A course of antihistaminic drugs should be given to get relief.
Also investigation for Serum IgE levels and Absolute eosinophil counts can give an idea about the gravity of the problem.

Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 7 hours later
So my pictures look like hives to you? Thank you for your response.
 
 
Answered by Dr. Rohit Batra 14 hours later
Dear Patient,
Thanks for your follow up.
YOu can get a relief in your symptoms in a couple of days once you start the treatment after investigations. Antihistaminic drugs are the mainstay for such conditions.

Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 11 hours later
Dr. Batra,

Thanks for your response. You did not answer if my pictures were hives, so I suppose they were. They are much better now, but I am still left with some patchy redness on my face.

Is it common to breakout in hives the next day after consuming alcohol? I was flushed when I was drinking the alcohol then I got the hives the next day. My face will look swollen and I will have some red bumps/hives???

Also, around my menstrual period, my face will have some red bumps that disappear quickly and I will look slightly swollen. I will also have very itchy eyes and stuffy nose.

And I am not sure if this is related, but I have a lot of dry, red patches on my face. I also have it along side of my nose which is flaky. My skin is so very dry and there is some redness that gets worse with showers, exercise and alcohol. Could this be seborrhoeic dermatitis considering I already suffer from other skin allergies? It's under my eyes near my nose, on either sides of my nose and randomly around my face on my cheeks. It's hard to see in photos though but I will try to take some so you can see.

Thanks so much- XXXXXXX
 
 
Answered by Dr. Rohit Batra 40 hours later
Dear Patient,
Thanks for your follow up.
Yes , your pictures suggest that you are suffering from allergy resulting in hives.
Hives or allergy can occur to anything and alcohol, wines, cheese with alcohol etc are common allergic stuffs which can lead to hives.
Seb Dermatitis is a condition that affects scalp , sides of nose, ears and upper chest and your symptoms are near to that.

A person who is sensative can develop allergies of various kinds - skin, nasal symptoms, atopic etc and hence such symptoms are common in persons who are allergic.

Bumps and swollen face can occur in patients during menses and are related to the hormonal shift that take place during the periods . Such things are nothing to be worried about.

Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 2 days later
Dr. Batra,

Thank you for reply. I have a couple other questions for you. It seems that after a hot shower or being out in the sun, my face will feel tight. I also will get a burning rash on my forehead. I uploaded 2 pictures to this query so you could see my forehead. Can urticaria/hives cause tightness in face and rash on forehead? My skin also is a little blotchy in normal conditions. Allergies?

My allergist explained that people with allergies can flush with alcohol and exercise which I do. When I exercise in hot temperatures, my face will look very red. My face will also flush with alcohol occasionally.

Do you have any idea what would cause the tightness in my face after being out in the sun or hot showers? Please view the new photos that I uploaded.

Thank you so much- XXXXXXX
 
 
Answered by Dr. Rohit Batra 8 hours later
Dear Patient,
Thanks for your follow up query.
Patients who are allergic and have fair skin can flush in any condition that leads to rise in body tempreture . The redness is prominent because of fair skin and is transient i.e it settles down as the body reaches a homeostasis.
There is nothing wrong and this is a protective phenomenon of the body to drive away the intense heat by causing vasodilatation of the affected area and decreasing the tempreture.

alcohol also can cause flushing and that too is transient in nature.
To prevent such a situation only preventive measures like avoiding hot tempreture, exercise and drinking alcohol can help.

Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 13 hours later
Thank you for your reply. The forehead rash seems to occur after taking warm baths or showers. The rash tends to burn a little bit and makes my forehead feel tight. Is that another form of hives, possibly cholinergic urticaria? Doesn't that occur with rises in body temperature?

Ok, I see what you're saying that people who have allergies tend to flush easier than others. Do you know what that is or what causes it? Also, can allergies cause skin to look blotchy at times- like have some permanent redness?

Thanks so much, XXXXXXX
 
 
Answered by Dr. Rohit Batra 10 hours later
Dear XXXXXXX
Thanks for your repeat follow up.
Yes, Cholinergic urticaria and Heat Urticaria correctly summarise your symptoms.
Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 20 hours later
Dr. Batra,

Thank you for your message. So Cholinergic urticaria and Heat Urticaria are why I flush with exercise, hot showers and occasionally with alcohol? Does anxiety worsen the problem? Can Cholinergic urticaria and Heat Urticaria worsen around my menstrual cycle?

Would medications like singulair help this in addition to zyrtec or allegra? Should I take an antihistamine more often? Would a beta blocker like propranolol be helpful as well?

Do you think it would be useful to follow a low histamine diet?

Thank you so much!! XXXXXXX
 
 
Answered by Dr. Rohit Batra 33 hours later
Dear Patient,
Thanks for your follow up query and sorry for the delay in respoding.
Yes, you can take antihistaminics more often to control the symptoms.
Propranalol would not do any good in your case.
Low histamine diet is also not a very good idea as in totality thats not possible and hence the effect of same is contraversial.
Rather , you can add ranitadine with antihistamincs so that both the receptors 1 and 2 are countered and relief of symptoms are there.
Drugs like singulair or monteleukest are good adjuvants as they can help in stabilising mast cells and give you relief.
Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
Follow-up: Noticed itchy blotches and swelling on face. History of dermographism urticaria. Could it be rosacea? 31 hours later
Dr. Batra,

Thanks for your reply. I will give singulair a try.

Is it normal for some of that redness to stick around on your face- skin to look a little blotchy at times in allergy prone people? I also tend to get a rash and blotches on my face when I sweat. Is this Cholinergic urticaria as well?

Can Cholinergic urticaria and Heat Urticaria worsen around my menstrual cycle?

Thanks again, XXXXXXX
 
 
Answered by Dr. Rohit Batra 40 hours later
Dear Patient,
Thanks for your follow up query.
Urticaria can be cholinergic, heat urticaria can give rise to erythema on face.
Also people with fair skin are prone to get blotchy skin with slightest of tempreture variation.
Menstrual cycle is related with changes in hormone and body tempreture - both can lead to oedema and eruthema and is normal with a few.

Erythema alone should not be confused with symptoms of urticaria.

Regards

Dr.Rohit Batra
Above answer was peer-reviewed by
 
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