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What Is The Cause And Treatment For Urticaria?

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Posted on Mon, 28 Apr 2014
Question: Hello, I suddenly started urticaria in December on my hands at work along with headache, nausea, breathing problem and chest tightness. Everybody suspected I must be allergic to exam gloves. But it is vinyl and nitrile, non latex gloves. I might be allergic to vinyl because I have bandaid issues each time I use it, but not much of trouble just a red skin underneath of adheqsive. No other health problem or past health problem in my lie. I have been very healthy until the hives started in Dec. I am age 50 female. The hives are very hot, painful and deep itch, it makes one blister about on the middle of hives at the end. Takes a week to heal but a itch stays for more than a month on the location if the hives, also makes dark discoloration on my skin, my hands looks like polka dots for many months. I can still see my first hive in December, the several dark spots on my hands. I had a hard time dealing with it because I cannot sleep for two, three days after hives starts. I saw three General practice doctors, they did blood testing, no sign of immune diseases,but my igE level was extremely high. I saw Dermatologist and Allergist after that. Skin prick test at Allergist in February found I am very allergic to dust mites, cockroaches, mildly to cats, little allergy to dogs, rag weed, and box elder. I never knew I even had allergy like that until that day. A week after the prick testing, I had a bad hives on my arms. My work told me do not come in to work until I recover and do regular shift, and find out what I am allergic to, I am staying home since the end of January after major oral steroid side effect, it was very bad, I was sick for three weeks straight after my doctor stopped the prednisone. I had to stop taking it only a week after the steroid therapy because of bad breathing problem, sweating, heart palpitation, headache, insomnia, lost 16lb. Whole month in February, I had to stay at home to wait for Allergist and Dermatologist appointment at home. In Feb, I had no other hives started except the one after the prick test. Dermatologist did contact allergy patch test last week for most of glove additives, house hold chemicals and cosmetics. He concluded I don't have any contact allergy, but I had a three big hives on my arm with the patch test. He said, I have systemic urticaria since I had two major hive episode in this month after I had Nicorrette lozenge, another one was maybe from fast food, but it could be from ibuprofen or Allegra, also Tagamet I am taking for allergy after March. . I never took medication daily like that in my life, and I have stomachache with the medication, but not major side effects. so I don't know what caused my hives at home. The negative suspicious reaction to Thimerosal could be something, but he still thinks it was a negative result. Thimerosal is commonly found vaccines, antiseptic spray, non-soap cleaners, contact lenses solution, and prick test solution. He said, I have to go back to Allergist for more testing for Latex allergy and food allergy. Dermatologist also did skin biopsy and found it was urticaria with numerous Eosinophils count. I found many article online about Dust mites, it says dust mites does affect skin, makes urticaria and it could have allergy shock, even death. But I don't have any respiratory issues in past like Asthma at all, I only have runny nose when I do heavy cleaning in dusty environment but never disturbed my life, I blow my nose and take benedryl after that, it is quickly fixed. My work has a big very old couch, and I sit and lay down on it during my shift after residents go to bed . The unit I work, the room is carpeted I also do house cleaning (wiping, sweeping and cleaning bathroom, kitchen etc. because I work at assisted living housing. I also pass medication and do personal hygiene work as well. I wonder what was initially causing my hives, but as long as no chemical contact allergy, I wonder if dust mite is causing this bad hives and breathing difficulties at work. I wonder if anyone out there can tell what kind of medical problem I am having. No one could tell me exactly what I have. I am very scared and tired. I want to go back to work ASAP. Please give me your insight about me.
doctor
Answered by Dr. Sujoy Khan (12 hours later)
Brief Answer: Atopy with chonic (idiopathic) urticaria Detailed Answer: Hello, Welcome to Healthcare Magic and thank you for writing to us. It seems that you not only have atopy (a tendency to allergy, as manifested by high total IgE and multiple positive blood results) but also suffering from urticaria. 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 XXXXXXX Each crop of skin lesions usually lasts less than a day, but fresh crops can appear one after the other. Episodes. Those that go on for more than six weeks are called chronic urticaria; shorter attacks are called acute urticaria. Causes are unknown in most cases - although infections, drug sensitivities, thyroid abnormalities (antithyroid antibodies), iron or Vit B12 deficiency and underlying autoimmune diseases such as diabetes can make it difficult to manage. I would urge you to discuss with your doctor about the aforementioned conditions. Your doctors will know individual test to ruled them out. I do not think further latex allergy testing or extended patch tests to more chemicals will be useful. It may however mislead you and cause unnecessary anxiety if there are mild reactivities to some chemicals. Further, you might need long acting antihistamines (Fexofenadine 180mg plus Atarax 50mg at night) for 3-6 months. And occasionally stronger drugs such as ciclosporin may need to be contemplated. Best Wishes.
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
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Answered by
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Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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What Is The Cause And Treatment For Urticaria?

Brief Answer: Atopy with chonic (idiopathic) urticaria Detailed Answer: Hello, Welcome to Healthcare Magic and thank you for writing to us. It seems that you not only have atopy (a tendency to allergy, as manifested by high total IgE and multiple positive blood results) but also suffering from urticaria. 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 XXXXXXX Each crop of skin lesions usually lasts less than a day, but fresh crops can appear one after the other. Episodes. Those that go on for more than six weeks are called chronic urticaria; shorter attacks are called acute urticaria. Causes are unknown in most cases - although infections, drug sensitivities, thyroid abnormalities (antithyroid antibodies), iron or Vit B12 deficiency and underlying autoimmune diseases such as diabetes can make it difficult to manage. I would urge you to discuss with your doctor about the aforementioned conditions. Your doctors will know individual test to ruled them out. I do not think further latex allergy testing or extended patch tests to more chemicals will be useful. It may however mislead you and cause unnecessary anxiety if there are mild reactivities to some chemicals. Further, you might need long acting antihistamines (Fexofenadine 180mg plus Atarax 50mg at night) for 3-6 months. And occasionally stronger drugs such as ciclosporin may need to be contemplated. Best Wishes.