Brief Answer:
Chronic urticaria

Detailed Answer:
Hello,

Welcome to healthcare magic.

I understand from your query that you are having 2 problems -
1. Skin rashes from last 3 years
2. Fertility issue with your wife unable to conceive

Let me address the 1 st issue -

You seem to be having a condition called as chronic urticaria.
In about 90% of the cases, it is not possible to find out a cause for the urticaria, which is when we call it is “idiopathic”.

In only about 10% of the cases, it could be due to a specific food, medications and infections, or auto-immune.

Are you taking any kind of over the counter medications especially pain killers or dietary supplements, Ayurvedic concoctions, herbal remedies, etc? If so, try to see if it correlates with onset of rashes.

Do you have a bad tooth (caries) which troubles you on and off which you seem to ignore? If so, please get it treated as many times, the source of infection triggering the rashes could be a tooth infection.

I would also suggest you to get your thyroid profile checked as urticaria could co- exist with a thyroid abnormality. And sometimes, correcting the thyroid status would control the rashes to some extent.

Have you noticed that the rashes triggered by cold air (eg AC), sweat (eg, after a workout) or water (eg, after a shower). These are well known triggering factors.

But unfortunately, most of our patients fit into the idiopathic category.

I would suggest you the following –

1. Do go through the above checklist as you might pick up a clue to a triggering factor and try to exclude it.
2. You are already on the right track with respect to the dosing of the anti histamines. You could continue taking 1 antihistamine every 3-4 days after consulting with your doctor if it gives you symptomatic relief.
3. Avoid foods containing preservatives ( eg , canned food, colas , etc) and those containing food colourants ( eg, kebabs at restaurants which have orange colour) as they are potent allergens.
4. Keep a food diary and write down everything you eat on the day you get rashes. You can look for any common food, which repeats in the diary, eliminate it and see if it helps.

Unfortunately, it is not possible to say when your allergy will be “cured" and when you will get permanent relief. It depends from person to person. It will disappear as suddenly as it appeared. Till then try to play Sherlock Holmes and try to find the cause.

Your 2 nd issue-

This is with regards to your wife's inabilty to conceive.

According to definition, fertility investigations are recommended only after 1 year of inability to conceive.

With every menstrual cycle, there is only 20-30 % chance of getting pregnant. It should be timed during the ovulation period. This will be 2 weeks prior to the beginning of the next period. There are various ovulation detection strips available in the market today ( e,g- I can ). Your wife could use them to time the intercourse.

I am a dermatologist. I would advise you to consult a fertility expert if you have been trying to conceive for more than a year. There are several causes of infertility and the specialist will be able to guide you.

Hope this helps you.

If you have any further queries, I will be glad to assist.

Regards,
Dr. Johny Chacko

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