Q. On getting up in the morning, I have itching on my head, on the palms and ears. The itching is mostly at the areas prone to rubbing such as the neck, collar area, where the head touches the pillow, belt area, shoes, etc. After itching, red spots appear over the hand and around the neck. I don’t know the cause of the allergy. How should I solve the problem? I am taking medicines such as Histic 150, Zaditen and Aerius. The problem has come under control after taking these medicines but it recurs if I stop them. I also feel a little feverish after taking these medicines.
A. Your problem seems to be that of urticaria which has a number of causes. They are:
• Ingestants: (a) Foods cheese, eggs, nuts, fish, mushrooms, etc. (b) Food additives tartarzine dyes, etc. (c) Food preservatives (d) Drugs penicillin, salicylates, sulphonamides, etc.
• Injectants: (a) Insect bites (b) Injection drug, sera, blood, etc.
• Inhalants: Pollens, animal dander, etc. Infestation by parasites: Amoebiasis, giardiasis, hookworm, roundworm.
• Infection foci in the teeth, tonsils, sinuses or elsewhere. Physical causes/factors (urticarial attacks are brief lasting for 30-60 minutes):
(a) dermographism (write-on-skin) stroking the skin with a blunt metallic instrument results in an exaggerated response,
(b) Pressure urticaria due to pressure,
(c) Cholinergic urticaria decrease in core body temperature (small, intensely itchy papules)
(d) Cold urticaria on exposure to cold air or water
(e) Heat urticaria heated object, exposure to heat
(f) Solar urticaria sun exposure
(g) Exercise induced following exercise
(h) Aquagenic pruritus/urticaria on contact with water
(i) Vibratory urticaria handling vibratory instruments
• Contact urticaria – on coming in contact with potato, onion, nitrogen mustard, etc.
• Rule out underlying collagen vascular disorders, malignancy or any psychogenic cause.
• Idiopathic no cause found.
At present, you and your doctor need to explore the causes of uricaria. Often, it is a short-lasting event and may require symptomatic treatment with antihistamines for a few weeks.