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Suggest Treatment For Red, Raised Circular Welts In Scapular Area

Posted on Wed, 2 Apr 2014

Question: My husband has had about 4 unrelated episodes of waking with 2-3 nickel sized, red, raised (like a marble underneath!) circular welts. They appear out of the blue, we do not have bedbugs; I have never experienced anything. Usually on the inside upper arms or scapular area. He said they itch a lot, they are hot. I have put triamcinolone cream on them for a few days and they go away after 3 days or so. What on earth could be causing them? They do not appear as a typical spider bite; even a mild recluse bite, which I have had. No purulence, drainage, bleeding or "pinpoint" that would suggest a bite. They are usually in twos or threes. Any ideas where to start? He will be seeing a dermatologist, but as a new patient, they will be gone before we can secure an appt. Thank you!

Answered by Dr. Dr. Kakkar (10 minutes later)

Brief Answer: Urticaria Detailed Answer: Hello and welcome to healthcaremagic I am Dr. kakkar. I have gone through your concern and i have understood it. I would keep a possibility of Acute Urticaria. It can presents as itching and skin welts/swellings, which can be localized to a particular area or they distributed all over the body. Urticaria OR hives can occur due to various causes like(to name a few): --Infections(bacterial , viral, fungal) --Drugs(Pain killers/ antibiotics etc) --Certain foods and food additives/preservatives --Physical Urticaria: Cold temperature, Heat, Pressure(Prolonged Standing, Sitting), Dermaographism etc. --Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc --Autoimmune disorders like SLE, RA etc. --A few cases have no underlying cause and are known as idiopathic urticaria. I would advice you to get few basic lab tests like Hemogram, stool for ova/cyst, Urine routine, Chest X-Ray. An oral antihistamine like Fexofenadine (Allegra 180 mg tab) OR Loratadine (Alaspan 10mg tablet) once or twice daily for a week would be suitable. They are non-sedating and wont affect your alertness level. A topical soothing lotion like calamine would help you symptomatically. take care regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (1 hour later)

I wish I had a pic to show you; I'm a nurse (IM and Cardio) and have seen umpteen cases of hives, all types. Never like this, however. I will get him a derm appt. Thanks.

Answered by Dr. Dr. Kakkar (6 minutes later)

Brief Answer: ??Angioedema Detailed Answer: Hi Another close possibility would be Angioedema. Angioedema has the same pathogenesis as urticaria but the lesions are deeper as compared to urticaria. Though Urticaria is evanescent and usually lasts <24 hours, angioedema may last for days. Yes the picture would be of great help, if you can post. regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar