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What Causes Flushing Of Hands And Face With Itching?
Question: Have a female friend with mysterious symptoms, the worst unexplained allergic/anaphylactic attacks, for which she carries an epipen. These attacks seem to occur only when she is menstruating, about 3-4 day into her period, which makes her think it's hormone related; starts with flushing of hands and face, and itching, tongue swells, she passes out. She's in her mid-40s. One doctor suspects a related skin disorder (scleroderma). My friend is at her wits end with never knowing when she might have an allergic reaction and there's no known trigger, at this time.
Brief Answer:
Please give more details, carry epipen
Detailed Answer:
Hello.
Thank you for asking at HCM.
I went through your friend's history and would like to make following suggestions for her:
1. First of all, I would like to know whether she develops anaphylactic attacks ONLY during menstruation.
In that case, I could be hormonal or it could be related to any drug that she might be using during that period (for example, analgesics). Anaphylaxis reactions to pain killers are relatively common.
Rarely, it could be due to allergy from any particular thing/substance that she is exposed during menstruation for example, tampoons, etc. In that case, time of onset of allergic symptoms and exposure to that particular substance can be a clue.
2. If she having symptoms apart from menstruation also, then causes like - drug allergies, food allergies, air-borne allergies (dust mites, pollens) etc can be thought of.
3. As long as treatment is concerned, if the trigger causing symptoms cannot be identified, carrying epipen and use it as soon as symptoms of anaphylaxis appear is optimum strategy. If it is hormonal, a gynecologist consultation may also help.
4. I would also suggest her to note of physical activities, for example, in some people, anaphylaxis can be triggered within a few hours of exercise.
5. I would also like to know whether she is on any other regular medications or she has any other medical condition. I would also like to know how her latest reports. I would also like to know whether she has consulted an Allergist-Immunologist and whether she has had allergy testing.
Hope above suggestions and information will be helpful to her. I would like to say that identifying trigger in anaphylaxis is very challenging and it requires combination of both thorough history from the patient as well as support of investigations. Still many times it may not be possible to identify the trigger and carrying epipen remains the safest option.
I would suggest you to provide more detailed information about her symptoms and her medical condition as asked above, on follow-up. It will be my humble pleasure to help her with best of my knowledge and experience.
Should you have any further query, please feel free to ask on follow-up.
Wish your friend the best of the health.
Thank you & Regards,
Dr Parin
Please give more details, carry epipen
Detailed Answer:
Hello.
Thank you for asking at HCM.
I went through your friend's history and would like to make following suggestions for her:
1. First of all, I would like to know whether she develops anaphylactic attacks ONLY during menstruation.
In that case, I could be hormonal or it could be related to any drug that she might be using during that period (for example, analgesics). Anaphylaxis reactions to pain killers are relatively common.
Rarely, it could be due to allergy from any particular thing/substance that she is exposed during menstruation for example, tampoons, etc. In that case, time of onset of allergic symptoms and exposure to that particular substance can be a clue.
2. If she having symptoms apart from menstruation also, then causes like - drug allergies, food allergies, air-borne allergies (dust mites, pollens) etc can be thought of.
3. As long as treatment is concerned, if the trigger causing symptoms cannot be identified, carrying epipen and use it as soon as symptoms of anaphylaxis appear is optimum strategy. If it is hormonal, a gynecologist consultation may also help.
4. I would also suggest her to note of physical activities, for example, in some people, anaphylaxis can be triggered within a few hours of exercise.
5. I would also like to know whether she is on any other regular medications or she has any other medical condition. I would also like to know how her latest reports. I would also like to know whether she has consulted an Allergist-Immunologist and whether she has had allergy testing.
Hope above suggestions and information will be helpful to her. I would like to say that identifying trigger in anaphylaxis is very challenging and it requires combination of both thorough history from the patient as well as support of investigations. Still many times it may not be possible to identify the trigger and carrying epipen remains the safest option.
I would suggest you to provide more detailed information about her symptoms and her medical condition as asked above, on follow-up. It will be my humble pleasure to help her with best of my knowledge and experience.
Should you have any further query, please feel free to ask on follow-up.
Wish your friend the best of the health.
Thank you & Regards,
Dr Parin
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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