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Developed skin rashes, asthma, cough, wheezing and trouble in swallowing. Required treatment?

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Allergist and Immunologist
Practicing since : 1999
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30/F... I have recently within the past 3-4 months developed really bed asthma, coughing, wheezing, trouble swallowing. I have also developed skin rashes within the same time frame. Symptoms much like those of Dyshidrotic Dermatitis keep reappearing on my one finger, and a completely different rash (red hot circle) just appeared on the inside of my elbow. I have gained significant weight within the last year, but that might not be related, as I quit smoking last year and had bad side effects from a birth control shot. Also, sometimes I get very itchy on the skin where my ears XXXXXXX my jawbone and occasionally on my neck under my chin. Most recently my cough wakes me up in the middle of the night or early in the morning, so it is definitely worse at night, and I occasionally cough so hard that I slightly lose control of my bladder. I literally gasp for air sometimes when I inhale and then I cough so hard after that it has become painful-- but not like a sore throat, I'm positive that its much more serious that that. I have since developed a metalic-blood sort of taste when I cough really hard, which may or may not be related to my asthma inhaler, as I'm just not sure whats what anymore. Last month my doctor sort of brushed of my symptoms as asthma and stress/anxiety related. I explained to him that I woke up one night coughing really hard and that my inhaler didn't help, it instead made my heart race. He suggested that it was a panic attack brought on from being scared from my "slight" asthma attack. My mother has severe asthma, COPD, sleep apnea, and her mother passed away at a very young age of 32 due to breathing related issues, so I understand the severity of it all. I also understand that some of these issues are not necessarily hereditary, but that the ability to develop them could be. I am so confused. Any ideas what could be going on with me? I don't even know where to start with my medical treatment, especially since getting the snub from the last doctor. Please help!
Posted Wed, 28 Nov 2012 in Asthma and Allergy
Answered by Dr. Sujoy Khan 8 hours later
I am sorry to note that you are suffering from several symptoms, most of which is undoubtedly allergic rhinitis or rhinosinusitis with asthma.
The painful cough can be very distressing leading to incontinence problems particularly because of the raised intra-abdominal pressure that puts pressure on the bladder.
I hope you have had blood tests for allergies, specific IgE blood against several aeroallergens will be required (do not have to fast overnight) especially moulds that can trigger asthma attacks in the winter/damp places.
You can also have skin prick tests (provided not on antihistamines) against the aeroallergen (standard and extended) panels.
Tests such as complete blood count (to exclude anaemia), thyroid functions, liver functions, C3 C4, IgE (total), lung function tests will be very important considering the multiple symptoms. C4 blood test if normal excludes a problem with a protein that controls swelling unrelated to allergic triggers. Thyroid function is vital to ensure you do not have overt hypothyroidism that worsens allergies.
Another important test would be 25(OH)D3 levels that most people now seem to be deficient and have multiple allergies.
Treatment would depend on the results, but it is likely that Symbicort and montelukast will help significantly.
I hope that was useful.
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