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How can urticaria be treated despite being on Allegra, Prednisolone and calamine lotion?

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Posted on Tue, 3 Nov 2020
Question: Dear sir
I have been diagnosed as itching urticaria.On 24.02.2018 I was in a ceremony in which I slept on mattress which was little bit dirty as it is normal in celebration.Next day I felt some itching skin with red rashes.I taken Allegra -180 mg @ 2 times & ( montelukast + levocetrizine at night).On 28.02.18 I consulted skin specialist which prescribed Inj( Avil-2 ml) & Inj ( dexona- 2ml ) IM to be taken separately for 4 days in morning &
night.Tab Allegra - 180 mg @ 2 times;Presisolone-10 mg @ 2times & (montelukast + levocetrizine) at night with calamine lotion to be applied locally on red rashes area.
I am taking clavam- 625 mg & grinlictus syroup due to dry cough & wound in leg due to itching.
Situation is in control but still red rashes come. In night & is not completely under control.
Please advise as second opinion & how much time it will take to completely control the situation.Any drug to be lessened or increased.
Please advise in detail
doctor
Answered by Dr. Dr. Kakkar (6 hours later)
Brief Answer:

Kindly upload images

Detailed Answer:

Hello,

I request you to kindly upload a few images of the rashes, if possible and areas where you itch so that I am able to confirm and guide you better.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Kakkar (48 minutes later)
Photos attached.In morning at 07:00 hrs I have taken
1) 2ml avil
2) 2 ml dexona-
IM separately.
doctor
Answered by Dr. Dr. Kakkar (4 hours later)
Brief Answer:

Regarding urticaria treatment

Detailed Answer:

Hello,

You do seem to have Urticaria. You are already on systemic steroids {inj. Dexona and Prednisolone} and oral antihistamines {Levocetrizine and Allegra (Fexofenadine)} as well as inj. Avil.

I am not in favour of injections though you may take oral steroids i.e Tab. Prednisolone 20mg (after breakfast) for 10-14 days.

In addition, I suggest you maximize the dose of oral antihistamines e.g Levocetirizine (Teczine 10mg), twice daily and Desloratadine(Dazit 5mg), twice daily.

You may as well use topical antipruritic lotions e.g those with pramoxine hydrochloride, calamine and menthol as ingredients like Atarax lotion.

Apart from that, I would also like to treat you empirically for scabies. For that, I would suggest 2 doses of ivermectin 12mg tablets, a week apart.

These are prescription medications and I advise you to kindly talk to your local practitioner for a prescription of the same.
To summarize - stop injectables. Continue with oral prednisolone tablets 20mg for 10-14 days.

Maximize oral antihistamines for 2 weeks (Levocetirizine, twice daily and Desloratadine, twice daily).

It would worth taking an antacid like pantoprazole on an empty stomach while you are on oral prednisolone. Treat empirically for scabies.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Dr. Kakkar (42 hours later)
Dear sir
Thanks for replying & I have shown the advice given by you to my local practioner & he agreed .I am doing well.My wife also developed some minor red rashes not to a large extent.It is communicable.??? please advise.
Sir
I am suffering from adrogenetic alopecia as stated by you when I consulted you through HCM.
Can I continue minoxidil 5 % & finasteride 1mg as treatment as most of the hair from scalp is going out.I have fatty liver ;will there is negative side effect on liver & libido; sperm count.

Thanks.
doctor
Answered by Dr. Dr. Kakkar (9 hours later)
Brief Answer:

Regarding itchy rashes and androgenetic alopecia

Detailed Answer:

Hi.

Scabies is communicable. You wide can take the same treatment that I had advised you for scabies.

As far as androgenetic alopecia is concerned, minoxidil and finasteride are approved remedies for it and safe for long term use.

Finasteride may have a temporary negative effect on libido in 1-2% of individuals at the start of treatment but the effect is not persistent and resolves on continued treatment.

Hope I have answered your query.

Take care

Regards,
Dr Kakkar S., Dermatologist
Above answer was peer-reviewed by : Dr. Kampana
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9628 Questions

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How can urticaria be treated despite being on Allegra, Prednisolone and calamine lotion?

Brief Answer: Kindly upload images Detailed Answer: Hello, I request you to kindly upload a few images of the rashes, if possible and areas where you itch so that I am able to confirm and guide you better. Hope I have answered your query. Let me know if I can assist you further.