Question: Hello, Doctors! Thank you so much for a great advice as always. i have learning a lot from you all. Now I understand that i have atopy and idiopathic urticaria with the very high igE in blood and eosinophil in my skin and need appropriate medicaiton to reduce occurence of my urticara. I am still confused one thing though... I read more online about urticaria, i read the trigger is not only one, such as dust mites, pet dander, medicaiton, chemical sensitivities, insect bites etc. Since I am Atopic, my trigger would be multiple? So far, i did Prick test and found that I am allergic to Dust mites (highly appergic) cats(mildly allergic), cockroaches (highly allergic). I had positive reaction to dogs, rag weed, and box elder, but they didn't come out with high level compare to other allergen. I did dust mites control obsessively at home, but have one cat (since my doctor told me it wouldn't hurt unless if I have many cats) and a dog, Bichon is at home. I had no hives for a month after the dust treratmente at home, but after I started taking Allergra and Tagamet regularly, i started getting hives along with stomachache. I had an urge of quiting cigareets, so i started taking Nicorettes lozenge, I had a major episode of hives on my both arms. After i stopped taking Allergra and Tagamet, also Nicorette, there are no more skin breakout with hivefs at home for two weeks. i experienced a severe side effict with Prednisone and needed to stoo suddenly by doctor's order after days in January, I wonder if i am also sensitive to multiple medication. At work, I still having breakout of my skin and bad a episode of headache, chest tightness, breathing problem, nausea in past. My work has old couch, not cleaned regularly over 10 years, they had a cat over two years (they gave up on cat becaue my manager was nice about my allergy), but I had to lay down on the couch (i work over nights and the couch is only one we have for resting) , I use house hold chemicals. I work a small residential unit (3 bed rooms, carpeted living room, one shared bathrooms, and dining area). I do a lot of hygine care for the reaidents, allng with passing medication. I sweep, and cleaning the common area and bathroom, also do laundry more than two loards XXXXXXX night. I feel that I was breathing in dust allergen while i was sweeping on the carpet (we don't vaccume after 9pm.). i understand i shoud not sweep carpet and stir dust mite allergen but cleaning floor is my chores. i also mop dining area and bathrooml. I have mild sinus problem if i sweep for long time, and blow my nose after words, but don't have Asthma, so I didn't think Dust mites were my allergen until the Prick Test. With my diagnosis of Atopy and idiopathic urticaria, I understand that it is hard to determine, allergens until further testing because I was not tested with food allergen, but i don't think my hives appeared after meal and i don't recognize other problem after eating. However, with my histologic facts, what can you tell so far? I want to know what would be triggering my hives and other symptoms as soon as possible and try eliminate allergen to have better quality in my life. Seriously, I am very tired of gurssing what is triggering my hives. i am in a great pain and sick feeling with my allergic episode because my hivds hurts badly when it happens, and i have sleep less for usually two nights with deep painful itchy skin because it is hot and swells badly and stays itchy for long time even after it heals. Also, the hives ccasionally end with a blister on the center of the wheel, and makes dark marks. the dark dots on my skin stays for more than two months, still visible and stained. Again, my question is, what can you see from my symptoms and what you would suddest to avoid exactly. I don't know what kind of testing is appropriate for me in the futre? my doctors i saw for this problem have been struglgling, i need more opinion. I would develop more allergy in the future? I am scared about it. I don't know if i have possibility to develop Asthma in the future, I want to be treated right and stay as healthy as I can sith good doctro's opinion and suggestion. Thank You.

Thank you, Dr. XXXXXXX It was a very clear treatment plan. i truely appreciate your opinion!

Wow, thank you very much. I didn't know i could directly talk to you again, Dr. XXXXXXX I will definately let you know how I get better. Since it was hard for me to deal with doctors in my area because they coildn't explan to me like you did. Now I feel that i have much better understanding of why my urticaria suddenly started. I will ask my doctor more of testing soon. Sincerely. Yoko