Creator: Dr. Jyotisterna Mittal
Published: 2016-04-06T05:17:36-04:00

Patient's Query

Hi doctor,

For the past seven months, I have been getting these reddish pink non-itchy bumps on my skin. They are round to oval and small to big. When they first appear, they were all over my arms, abdomen, back and on my thighs. Now they randomly show up here and there. I had a large one in my elbow crease and it went away after a day or two. Now, I have two small ones on my forearm and two larger ones on my back and one on my left lower abdomen. Every time I go to the doctor and they disappear. Some of them leave flat reddish like scar for a few weeks. Currently, I am taking Ativan and Metoprolol. But, I was not on these medicines when this rash began. What shall I do now?

Answer

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology

Hi,

Welcome to icliniq.com.

I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern.

I need to get a few more details about your lesions.

On an average, how long do the individual lesion last before settling down?
Any history of swelling on your lips or eyelids during the episodes? Any history of recurrent fever, joint pains, etc?

The Probable causes:

You seem to be suffering from chronic urticaria. It may be due to many things like chemicals, dyes, exertion, insect bite, perfumes, packaged foods, dietary protein allergens and may be idiopathic.

Treatment plan:

1. Usually long-term low dose treatment is required in the form of antihistamines. Example Levocetirizine-Montelukast combination. It consists of Levocetirizine 5 mg and Montelukast 10 mg. This can be taken twice daily in the morning and evening.
2. In severe cases, your doctor may prescribe you a short course of oral corticosteroids.
3. Use a medicated gentle cleansing lotion on your skin for bath like Cetaphil cleansing lotion.
4. Wear cotton clothes. Avoid allergens like pets, dust, etc.

Preventive measures:

1. If you find any causative factors such as any dietary substance, dust, exertion, etc., try to avoid it.
2. Apply calamine lotion over affected areas.

Regarding follow up:

Revert back with the answers to a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist

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Patient's Query

Hi doctor,

I do not have any swelling anywhere on the face during these episodes. They do not itch at all. So, I was not sure if they would be hives. They will last somewhere between few days and week.

Answer

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology

Hi,

Welcome back to icliniq.com.

Occasionally, hives may not be itchy. This may also be the case in angioedema and vasculitic urticaria.

Vasculitic urticaria usually persists for days. It may be associated with connective tissue disease. But, I assume there are no typical symptoms like chronically recurrent fever, joint pains, photosensitivity, etc., so chances are less.

Angioedema is usually non-itchy, but may be associated with some discomfort or pain.

The swelling is at a deeper level, so may persist for a longer duration.

It may be associated with bouts of abdominal pain, facial swelling etc during the episodes.

Investigations to be done:

For ruling out urticarial vasculitis, a skin biopsy from an individual lesion will be required by your dermatologist at the time the disease is active.

You doctor may carry out investigations for ruling out connective tissue diseases like ANA (anti-nuclear antibody), renal function tests , etc., if any suspicious signs and symptoms occur in future.

Regarding follow up:

Revert back with the investigation reports to a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist

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