Question: Hello, My skin biopsy revealed that I have numerous eosicnophil in urticarial leasion on my arm. I have learned so far by the help by Healthcare Magic doctors, my urticaria is Atopic allergy related. I have emvironmental allergies, my prick test revealed I am allergic to dust mites, cockloaches, cats, dogs, weed and tree pollen. I do not have regular sinus problem or Asthma, but I have breathing problem, cough, chest pain and tighness only when I was exppsed to heavy cleang with dusty environemnt in occasion. Otherwise, I am relatively healthy in my opinion except urticaria, recently I developped hedache with urticaria and also had breathing problem, tightness of chest, and throat closed up, and nausea foloows adter and I was sick for all day long, but I was recovered as my hives went down. Currently no new hives for two weeks, but I have itchy skin, i feel better after shower and skin remains clear. I understand becaue of my Atopy, I would have more allergen or substance that I would react to them, and I will keep consult my local doctro about it, but i found this article online and as far as I read in the article, eosinophil in skin would cause more of other eosinophila in other part of organs. Is my understanding correct? http://www.waojournal.org/content/pdf/1939-4551-2-9-213.pdf My question is would my Atopy skin condition would progress to Asthama or other organ problem if I cannot lower eosinophil in my skin? How can I treat eosinophil in my skin? I have not tested Blood Eossinophils yet. I need to ask my local doctor to run the test? i have eosinophil in my skin also means I have eosinophil in my blood? i will be waiting for your opinion. Thank you, XXXX

Thank you Dr. XXXXXXX It was a very helpful answer, one more thing I need to ask you. After your good overciew and possible future treamtnt, my question arised. I might be allergic to Prendisone. In past experience, i had a sever side effects with Prednisone at the begening if my first hives started in December 2013. Excessive sweating, heart pulpitaion, sudden weifht gain, huves on my neck, headache, chest pain, dizziness, insomnia following over nigt fever disrrihea. i started with 60mg and reduced to 50mg, then my doctor stopped it because of the severity of my adverse effect on the 6th day of the medicaiton. i gained 10lb during i was on prednisone in first three days and lost 16lb in the following week. i had two small hives on my neck in the third day of taking Prednisone, excessive sweating contenued for a week, and dizziness and headache staied 3weeks, then fever and diarreah happened while other symtoms subsided. i thiught it was from hyhidration. My local doctor recently told me it was because too much dose to start, my side effect woud be controled by the lower dose, but it was before they found my Atopy at my Allergist. I am scared to try it even in lower dose. I developed hives more during the couse of Antihistamine. I took Allegra and Tagamet, hives still started, but it helped itchy and pain of my hives, my hives still made a dark apot and it doesn't clcear up the color for 3-4 months. Do you suspect my medicaion is failing? I am not taking Allergra and tagamet because i wanted know if i was also allergic to polymer in the medication, i don't have hives now for two weeks. My skin is clear at this time at home. If I antihistamine was not effective enough and prednisone also cause trouble with me, my choice would be limited to treat eosinophilic skin? As you meneioned, I feel that earlier treatment with appropriate medicaiton would be needed soon enough before i develop Asthma, I am suer I need to go back to my Allergist for this matter. I need your follow up answer to have a better ideas and also be able tocatch up with my new doctor. Thank you.

Wow, it was the best treatment plan i have ever recived. I cannot say thank you enough I will definately tell my Allergist and PCP about this and get better. Thank you so much. Dr Vibek.