
Noticed Red Itchy Scaly Welt After Wearing Tight Dress. What Should I Do?

Thank you for writing to Healthcare Magic and also for uploading the picture.
This skin rash looks benign (i.e., not infected or one that could be caused by bed bugs) and is most likely a pressure-induced itchy lesion, sometimes called pressure urticaria. This diagnosis is more relevant if the rash is itchy and is obviously red.
The other possibility is a scratch from say, a sharp projection from the seat for which a mild antibiotic cream like neosporin should suffice.
If the rash is itchy, you can apply calamine lotion or take an antihistamine.
If the possibility of scratch secondary to say a nail is very unlikely, then you would not need a tetanus jab. If however, you have had a tetanus jab in the last 5 years, then there is no need for it either.
I hope this helps.
Best Wishes.


If this is pressure urticaria, antihistamine tablets (like fexofeadie 180mg or cetirizine 10mg) for 2-3 days is sufficient.
When applying neosporin cream, you can see the effect also in 2-3 days, the redess goes down in 24 hours.
Best Wishes.


If you have had urticaria before, then this is just another manifestation of the same problem.
However, if this is the first time, and there is good response to antihistamines, recurrence is usually not the rule.
Triggers of further urticaria include: itching or scratching (physical), infections, pre-menstrual state, thyroid abnormalities.
If there is no benefit from either antihistamines or neosporin cream, or if you developed more lesions, please see a doctor straight away.
I hope that helps.
Best Wishes.


The only test that seems worthwhile doing in urticaria (especially when it comes to th thyroid, and normal TSH) is TPO antibodies (thyroid peroxidase). This, if positive, is an indication of autoimmune hypothyroidism that can manifest years later (and hence a normal TSH).
It now becomes relevant given your past history that you are getting urticaria secondary to tight fitted clothing, and to it a component of physical urticaria. You should also note that secondary issues like alcohol consumption, pre-menstrual states that worsen urticaria or make it 'suddenly appear'.
Reflect testing with fT4 is not indicated with a normal TSH, unless you are on thyroxine replacement therapy.
Peeling nails and loss of hair can also sometimes mean there is an autoimmune component, and XXXXXXX test with C3 C4 levels will be helpful.
Best Wishes.

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