Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
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Patient's Query
Hello doctor,
I am 52 years old. I have had an issue with topical dermatitis\eczema for about a year and a half. I have been using steroid creams and anti-itch cream but it kept coming back on and off. Three weeks ago I started getting hives and before two weeks, they covered most of my body from my neck to my ankles. As per my doctor, I went on Prednisone and Cetirizine but it did not stop. Now I am on Methylprednisolone and Cetirizine and it seems to be getting a little better. I cannot figure out any triggers though, the itching and the hives are pretty much unbearable. It does not seem to be a sugar allergy, but I am uncertain about a gluten allergy. I have had a previous allergy test but revealed nothing except for allergy to a few animals, which I have none. I never had a gluten test.
My current medications are Amlodipine, Paroxetine, Wellbutrin, Famotidine, and Cetirizine. Methylprednisolone for the past four days.
Hello,
Welcome to icliniq.com.
I have seen the attachments. (attachment removed to protect patient identity). It must be difficult for you with the itch and the rashes. Can you upload the report of your allergy testing? Why do not you go ahead and get the flute testing? It is a blood test and not as costly as the routine allergy panel.
Secondly, when did you start Paroxetine and Wellbutrin? Were those started recently? Is there any correlation between their start and the development of the rashes? When you take the steroid tablets and antihistaminics are you better off? Do the rashes stay at bay then? Are there any triggers inside the house? Any insects or dust particles? Any history of change of place of stay?
Patient's Query
Thank you doctor,
I do not have the report of my allergy testing, but everything was negative except for horses, dogs, and cats. I am not familiar with flute blood testing, but I can look into that. What does that look for? Could this be a gluten allergy? I have no correlation with Wellbutrin and Paxil.
And yes, Methylprednisolone seemed to dissipate the situation. But I fear it is only temporary. The antihistamines do not seem to work very well for the itching or inflammation for that matter and there do not seem to be any triggers in the house. I just bought a new laundry soap so I am going to try that.
Hello,
Welcome back to icliniq.com.
I am sorry. It is not flute testing, it is gluten testing. Plain gluten testing is not as costly as a complete allergy panel testing. I think you should check for gluten sensitivity.
Nextly, you need to take steroids for some time. I agree it is temporary but you must take those for the current time being. To relieve itching you may try a stronger antihistaminic. Levocetirizine is a slightly milder antihistaminic than Hydroxyzine or Atarax or Avil. Try taking Pheniramine maleate or Hydroxyzine single daily dosage in the evenings and Levocetirizine in the morning. You may have to take antihistaminics for some long durations.
The allergy testing has to be done when you have not taken the antihistaminic for at least four to five days. I suggest you apply Histocalamine lotion all over the affected area twice daily after washing off the previous application.
I suggest you get a skin specialist (dermatologist) consultation for a second opinion.
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Otolaryngology (E.N.T)
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