Please Help!

**sam** · 03-02-2012, 07:08 PM

I would really appreciate it if you could all let me know what you think about the pics i have taken of my rash.. it comes up everyday once or twice for about an hour a time. i have been to the doctors and he cant decide on what it is. so he has sent me to a dermatologist but my appointment isnt untill june!, ive had this for 8 months now and i am thinking of leaving work through loss of confidence and embaressment if im honest. i never go out unless i have to, it basically makes me feel like a prisoner in my own body. please help me discover what this is.
Thanks!

**Dr.Deepak** · 03-02-2012, 07:40 PM

Could you please give some more details

At what time of the day does it comes
Does the rash completely disappear after few hours
Is it just on the exposed parts of the body ( does the lesion involve in the area covered with cloths)
Itching, burning sensation, pain anything present
Does it involve face
Were you on medications recently
What does your work involve
Do you have any other history of illness
Try to scratch the hand area with your nails and see if u get red raised rash along the line of scratch

**sam** · 03-02-2012, 07:55 PM

Thanks for the reply, it comes totally randomly. anytime of the day or night, it is a little bit itchy but it feels quite prickly? if that is the right word to use.. it comes up on my whole body. no reaction to a scratch my doctor tried this when he saw the rash, there is no pain from the rash but i do feel hot when it comes up.
i work in a factory so i come in contact with machines plastic metal..all sorts. but i worked there for 3 months without any rash.
really apreaciate you trying to help!

**sam** · 03-02-2012, 08:15 PM

oh and i forgot to mention, when ever i play any sport it comes up.. and if i walk fast!

**Dr.Saiyan** · 03-03-2012, 07:23 AM

hi sam! though your picture is not very clear but as per the history you have given the first impression that comes in mind is Cholinergic urticaria,which is induced by increase in your body temperature or sweating aggravated by various factors like exercising,eating spicy food,emotional stress, taking hot shower, Transitioning from a cool environment to a hotter environment without allowing the body time to slowly acclimate to the temperature difference (such as walking from a cold room to a hot room),emotional response etc.This can start any age between 10-30 years and can lasts for many years. this generally starts with the sensation itching, burning, tingling, warmth, or irritation that precedes the onset of numerous small pruritic wheals which lasts for about 1 -2 hrs wit average of 80 min.the wheals may appear anywhere on the body.

i guess this u can be diagnose yourself by climbing stairs or doing any exercise that heats up your body and produces sweats and watching for the rashes to appear.There is no cure for Cholinergic urticaria, and treatment options are often limited. Some common treatments include taking antihistamines , avoiding known triggers including various other symptomatic treatments.

As u are working in factory where u come in contact with may allergens like dust ,mites,fur of animals,metals etc etc so we cannot exclude the possibility of allergic dermatitis.so i wanna suggest you see dermatologist and try to provide him as much clues as possible ,so that its easy for him/her to make diagnosis and proceed with the treatment.do keep us informed about your condition,we will be happy to hear from you.

**sam** · 03-03-2012, 07:47 AM

Ok thank you for your help, it doesnt sound too promising.. i just hope something can be done.

**Dr.Deepak** · 03-03-2012, 10:17 AM

As saiyan said i do feel like Cholinergic urticaria. Yup treatment doesn't sound promising and is very challenging for both patients and dermatologist. So the primary treatment measures are avoiding the triggering or aggravating factors and use of topical anti-itch medications with regular use of newer 3rd generation oral H1-antihistamines like fexofenadine hydrochloride which you are currently taking. However in many patients with Cholinergic urticaria, first or second generation antihistamines might work well and works even better with combination therapy with 3rd generation antihistamines.

So taking one 3rd generation in the morning and second generation at night while slowly decreasing the dose to alternative days followed by every 2-3 days further tapering every weeks gradually might give the beneficial result. For severe cases your dermatologist may prescribe corticosteroids for short period or other alternatives like IgE therapy, desensitization with autologous sweat and so so..

Being said that it is wise to consult a dermatologist personally and ask for an opinion on medication. Diagnosis can mistaken just by looking at the pics. Please do keep in touch and don't hesitate to ask anything you want to know.

**sam** · 03-03-2012, 10:47 AM

Thanks for the help, il let you know how i get on

**sam** · 04-10-2012, 10:13 PM

Just to update everyone, i still have the problem...but i have an appointment in the morning to see the dermatologist, ive had to go private because of the long waiting list! (£175) So i hope to find out more. I will let you all know how it goes.