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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Chronic Urticaria

Hi, I am suffering from allergy since end of August. The diagnosis is different from different doctor. One said is chronic urticaria, another said is due to food allergy, another said is hormone changes and cause my immune system to attack when ever I had ate something which will cause allergy.
After observation, I notice that prawn, crab stick, shrimp paste will cause my allergy. At the beginning, it only appear only on my back thigh. The rashes will start with like mosquito bite and very itchy, and getting more and more after I scratch. It will appear on the next or next two days after I ate the food which will cause my allergy.
As advised by doctor, I had took a 10 day course of Aerius and Asthator. The rashes came back 5 days after my course had ended. Then, I took Loratadine for another 10 days. Like previous, the rashes came back after 5 or 6 days after my course had ended. I noticed that the allergy reaction and area affected become more serious each time I stopped. Now, it even appear on my arms, waist, swollen on my lips, cheek, eye lids, neck. My lips or eye lids will swollen 15-30 min later if I ate the food which will cause the allergy.
Currently, I follow the advice from a doctor, not to completely stop eating food that will trigger the allergy to let my body to accept the food. I will only take Loratadine if the rashes appear a lots.
Pls advise what should I do to stop or cure this forever?
Fri, 19 Dec 2014
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Allergist and Immunologist 's  Response
Hello,

Thank you for asking at HCM.

I went through your history and would like to make suggestions for you as follows:

1. Of course, I would first think of "Chronic Urticaria" as a diagnosis, but it is important to find the cause.

2. As you have symptoms after taking prawn, crab, shrimp, etc. I would suggest you to go for allergy testing (both serum specific IgE and skin prock tests for sea foods). This will help to know whether you are actually allergic to sea foods. (sea foods are very common to cause food allergies and avoidance is the best measure)

3. However, as you have chronic urticaria and also, as you develop symptoms after 1-2 days of consumption, I would suggest you other investigations for chronic urticaria also.

For my chronic urticaria patients, I advise Complete blood counts with ESR, C-reactive protein, serum ANA, thyroid profile, complete urine and stool analysis as primary investigations. However, I would mention here that nearly 25% of patients with chronic urticaria have all normal reports.

4. For treatment purpose, I would suggest you to avoid foods that cause your reactions (the most important aspect of any allergy, I would disagree with th concept of "acceptance by body").

5. I would also like to review your other medications like pain-killers, contraceptives, and some others which might be contributing to urticaria.

6. I usually suggest my such patients to take an antihistamine like hydroxyzine or fexofenadine or loratadine for 6 weeks regularly.

7. I also suggest them to avoid too hot/spicy foods and sudden temperature differences. Woolen, tight clothing can also irritate skin and hence not preferable for urticaria patients.

8. I usually prescribe my such patients a good multivitamin-multimineral supplement and high dose vitamin D after checking vitamin D levels, which might help in some chronic urticaria.

9. If psychological stress is a concern for you, please adopt some relaxation strategies as stress can worsen urticaria.

10. Please do not scratch the itchy areas as it aggravates itching. I would suggest you to apply a lotion like calamine over itchy areas instead of scratching them.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask at HCM.

Wish you the best of the health ahead.

Thank you & Regards.
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Suggest Treatment For Chronic Urticaria

Hello, Thank you for asking at HCM. I went through your history and would like to make suggestions for you as follows: 1. Of course, I would first think of Chronic Urticaria as a diagnosis, but it is important to find the cause. 2. As you have symptoms after taking prawn, crab, shrimp, etc. I would suggest you to go for allergy testing (both serum specific IgE and skin prock tests for sea foods). This will help to know whether you are actually allergic to sea foods. (sea foods are very common to cause food allergies and avoidance is the best measure) 3. However, as you have chronic urticaria and also, as you develop symptoms after 1-2 days of consumption, I would suggest you other investigations for chronic urticaria also. For my chronic urticaria patients, I advise Complete blood counts with ESR, C-reactive protein, serum ANA, thyroid profile, complete urine and stool analysis as primary investigations. However, I would mention here that nearly 25% of patients with chronic urticaria have all normal reports. 4. For treatment purpose, I would suggest you to avoid foods that cause your reactions (the most important aspect of any allergy, I would disagree with th concept of acceptance by body ). 5. I would also like to review your other medications like pain-killers, contraceptives, and some others which might be contributing to urticaria. 6. I usually suggest my such patients to take an antihistamine like hydroxyzine or fexofenadine or loratadine for 6 weeks regularly. 7. I also suggest them to avoid too hot/spicy foods and sudden temperature differences. Woolen, tight clothing can also irritate skin and hence not preferable for urticaria patients. 8. I usually prescribe my such patients a good multivitamin-multimineral supplement and high dose vitamin D after checking vitamin D levels, which might help in some chronic urticaria. 9. If psychological stress is a concern for you, please adopt some relaxation strategies as stress can worsen urticaria. 10. Please do not scratch the itchy areas as it aggravates itching. I would suggest you to apply a lotion like calamine over itchy areas instead of scratching them. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at HCM. Wish you the best of the health ahead. Thank you & Regards.