Dr. Dilip Kumar Meena
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My father is having on and off itching and rashes all over his body. The itching is more during the night. We did not consult any doctor due to lockdown. His current medications are tablet Plavix, Cardivas, Lipvas, Silodal, Cresar, Neurobion Forte, Zoryl-MV 2, Volix, and Human Mixtard Insulin. What tests are needed to rule out the cause? Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern. Your father has urticaria with scabies. It is challenging to evaluate further without a physical examination. Kindly answer me the following to help you better. Do anyone else in your family has itching? Do the rashes look like raised mosquito bites and subside in few minutes? Are there any little bumps on his abdomen, extremities, or in the finger spaces? Revert with the answers. Take care.
Patient's Query
Hello doctor,
Thanks for the reply. Yes, his elder sister has similar itching and rashes. The rashes look like mosquito bites and disappear within few minutes. My doctor prescribed tablet Atarax 25 mg and Okacet 10 mg. These tablets worked for few months, but the rashes reappeared after discontinuation of the medications. Is there any specific test to analyze this condition? Kindly help.
Hello,
Welcome back to icliniq.com.
It seems he has chronic urticaria, and there are no specific blood tests for urticaria. And the right way to treat is to take medicines regularly for few weeks to few months with regular follow-ups. I suggest you take the following medications for four weeks. Take Tablet Teczine-M (Levocetirizine and Montelukast) once at night and Tablet Vermact 12 mg (Ivermectin) once a week for two weeks. Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
My dad followed the medicine for one month as per your previous recommendation. We have got Ivermectin and Montelukast tablets. The course was over by last month, and he started to have itching again. Now, for the time being, he is taking tablet Atarax 25 mg and Okacet 10 mg. Kindly suggest.
Thank you.
Hello,
Welcome back to icliniq.com.
I can understand your concern.
If his condition is controlled with the tablet Teczine-M, then he can continue with it. Atarax, Okacet, and Levocetirizine containing hydroxyzineare all of the same class of drugs, known as antihistamines. I prescribed Levocetirizine with a Montelukast combination, which has slightly better results. The goal is to reduce the antihistamine dose to as low as possible and still have the disease under control.
Kindly consult a specialist, talk to them, and take the medication with their consent.
I hope this information will help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
He is continuing Teczine 5 mg daily and looks like it is controlled with a single dose. Last month he was not able to pass the urine and went back to our treating doctor, and had been identified with a bladder tumor after a USG scan, and CT, IVU scan.
TURBT was performed 15 days back, and attached is the biopsy report, we are waiting for the next action plan from the treating doctor. Is there any relation between bladder tumor and chronic urticaria? Kindly suggest.
Thank you.
Hello,
Welcome back to icliniq.com.
I can understand your concern.
Chronic urticaria is mostly an idiopathic condition; the cause is unknown in most of the cases. In other cases, infection, drugs, and very rare tumors can also be associated with it. But the association can be a coincidence too and treating malignancy is no guarantee for urticaria cure. I advise you to follow the below-mentioned suggestions.
If urticaria is controlled with a single dose of Teczine( Montelukast), try reducing the dosage to once every other day. Otherwise, go back to once a day dose.
I hope this information will help you.
Thank you.
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