Q. I am a 22-year-old boy from Bangalore. Since early this year, I have been suffering from an itching sensation all over my body. I used to scratch my skin and the itching would subside. Initially, it was not severe but by midyear, it became unbearable and whenever I would scratch, rashes erupted (similar to a scar left on the skin after an operation). Once these rashes erupted, the itching used to vanish in that place. The rashes would die down in an hour or two at the place where I had scratched but would erupt at some other place. I noticed that I had this problem while I was indoors. Whenever I would go out in the sun, the itching would reduce. I consulted my family doctor and he prescribed Airitis (levocetirizine dihydrochloride 5 mg), which I took for nearly 2 months every morning. Whenever I took these tablets, I was free from the problem. But when I stopped taking this medicine, the itching reappeared. Meanwhile, the doctor asked me to monitor my eating habits for 2 weeks, he wanted me to make a list of all that I ate during that week and also recollect if there had been any change in my eating habits at home since April. Since there was absolutely no change in my eating habits he prescribed Airitis. But I did not get any relief and consulted a skin specialist. He gave me 20 tablets each of Zyncet 5 mg and Famonite 40 mg, which I had to take every morning after breakfast. After the course was over, within 2 days, my problem resurfaced and he asked me to continue the same medication for another 20 days, after which the problem reappeared. He then replaced Zyncet with Des Loritidine for 20 days, and after 20 days the problem reappeared. Now not only is the problem of itching limited to indoors, even when I go out, I get absolutely no relief. I met the skin specialist yesterday and he replaced Des Loritidine with Sizon forte. Both our family doctor (who also does the allergy testing) and the skin specialist are against going in for allergy testing as they say that it does not guarantee identification of the allergen and thus would not help in finding a solution to my problem. I have tried everything, from vacuum-cleaning my house to regularly washing all the bedlinen at 80-90 degree Celsius in the washing machine, to avoiding certain foods such as cucumber, brinjal, whole grains such as chana, moong, and many others, and not eating outside. I do not take soft drinks either. Please suggest a solution to my problem as soon as possible. I know that the best solution is to avoid the allergen, but the biggest problem is that I am unable to identify the allergen.
A. You are most likely suffering from urticaria. To be certain of your diagnosis, you need to get examined when you have a rash. There are numerous causes of urticaria, other than food and aeroallergens. It could be due to infection, infestation of the gastrointestinal tract by worms, injectants including insect bites, ingestion of drugs or chemicals in preserved foods, part of systemic disorders, psychogenic causes, etc. Sometimes, in spite of all investigations, a cause may not be found. You need to undergo investigations to find the cause. Till that time you should use antihistamines such as Des Loratidine; if not controlled, tablet Atarax 10 mg or 25 mg thrice daily or systemic prednisolone on the advice of a doctor. Intradermal tests for allergy are not very predictive of the allergen involved.
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