What causes hives on back?

Posted on Wed, 8 Oct 2014 in Skin Hair and Nails
Question: 34 year old man. "Hives/bumps" started about 2 weeks ago, on back. Now spreading from back to sides, chest and neck. Started keppra approx 30 days ago. Took benadryl and used hydrocortisone 1% with no relief. Slightly itchy. Not raised alot or filled with liquid.
Answered by Dr. Geetika Paul 1 hour later
Brief Answer:
Need to rule out drug rash

Detailed Answer:

I understand your concern regarding your skin problem and I hope I am able to help you in the same.
I have seen the attached pictures.
You seem to have developed skin lesions of pityriasis rosea which is a harmless skin condition. It can cause development of red itchy scaly skin lesions over the chest ,back, upper srms and upper legs . Now this is basically a self limiting skin problem which means that it will heal itself in four to six weeks.
Now you have been taking tablet keppra since four weeks. Although the skin rash does not seem to be associated with the drug that you have started, but in case of anti seizure medicines, it is very important to be cautious. Any skin rash that develops while the patient is on any anti epileptics needs to be examined by a dermatologist.
So my advise would be that you should try to see your treating doctor or a dermatologist as soon as possible so that you can be examined in person to rule out the possibility of a drug rash. At the same time, you need not be very worried since my first diagnosis in your case is pityriasis rosea only. A direct examination of the patient is essential for confirmation of the diagnosis.
In the mean time, you can continue to apply cortisone skin cream and take some oral antihistamine tablet along like tablet claritin once a day

Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
Follow up: Dr. Geetika Paul 1 hour later
Thank you. I spoke with my Physicians Assistant and he believes it is due to the Keppra (he has not seen the pictures though). He suggested I taper to 500 mg Keppra over the next 3 days and if it's not better he will prescribe a course of steroids.

After looking at pityriasis rosea it looks like what I have. Is it odd mine started on my back, and now is going up my neck? It feels more like a sunburn then itchy. Also I cannot see a heralds patch?
Answered by Dr. Geetika Paul 3 hours later
Brief Answer:
Watch over the progress of the rash

Detailed Answer:
Hi again

It is always good to be over cautious with anti epileptics. So it is nice that you have discussed the issue with your doctor.
But since in pictures, the rash looks more like pityriasis rosea,it becomes necessary for us to reach an exact diagnosis.
P rosea occurs only on the sites of body mentioned earlier. It does not mostly come up on the face, palms, soles or over the mucosa like oral cavity or genitals
So what you can do is, that you should carefully watch the progress of the rash. If it develop at any of the above mentioned sites,then you might have to see a doctor and might need to be prescribed oral steroids.
On the other hand, p rosea can even develop without a herald patch. It is a harmless skin problem in which there can be development of new lesions till upto eight weeks. So nothing much has to be done in this case

Dr Geetika XXXXXXX
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
Answered by
Dr. Geetika Paul


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