Itchy dry rashes on the body. Difficulty in breathing, swollen feet. Responds to zyrtec. Is this life threatening?
Patient: hi, my name is jawaria and since september i started to get these rashes that looked like bruises, very itchy, i scratched them a hell lot and now they are at my back, arms, neck , chest and also now on my torso, i m very scared as i dont know what it is, they are dry but don t go away, they are faded purple and the ones on my chest are faded red, i do not have any food allergies , once in a while i get difficulty breathing and my feet swell up, for that i take zyrtec and it goes away, please do help me as i do not know what this is or whether this is life threatening or not, i don t even have insurance and i m scared how will i treat this Doctor: Hello Jawaria, I am sorry to note your present state. The condition that you describe is consistent with urticaria, and very itchy red hives that fade away but reappear within a few hours. Some attacks on the skin are raised and known as angioedema due to the chemical called histamine released from mast cells. These cells are present in the lips, tongue, skin, chest, gut etc and therefore wherever histamine gets released, you get the specific organ related symptoms. Another condition called urticarial vasculitis definitely needs to be excluded and moreso when there is no response to antihistamines. 80% of people with urticaria do not have any allergies which is the case with you. Long-acting non-sedating antihistamines like fexofenadine 180mg once daily plus/minus cetirizine 10mg at lunchtime/evening is required for 3 months. Occasionally the treatment may need to be longer if there is a recurrence. Tests such as CBC, LFTs, renal profile, TSH TPOabs are standard investigations to exclude a secondary cause. Most people go into remission so do not worry. Thanks.