Archive for March, 2012

Chronic Hives

As springtime yard work commences, I see a number of cases of contact dermatitis.  Some cases are just a skin irritability, others can stem from the handling of last year’s crop of poison plants like, ivy and sumac.  There is a difference between an irritation and full blown chronic hives.

A chronic outbreak of Hives is defined by symptoms lasting longer than 6 weeks. When hives become chronic they can become severely itchy. The pruritus (or itch) keep people awake for long periods destroying their sleep requirements and as well as their  waking hours. Total or widespread hives on the body can make the sufferer unable to participate in the daily activities of life.

Chronic hives are most likely caused by autoimmune or infectious causes. Such markers like antithyroid peroxidase or thyroglogulin can indicate an autoimmune disease. Positive double stranded DNA Rheumatoid factor or sjogrens antibody can indicate a tendency towards rheumatoid disease. Some other blood measures can indicate incipient diabetes. Elevated immunoglobulin indicate a tendency towards autoimmune disease and positive viral titers to hepatitis c can  indicate an present infection causing the hive.

At times patients who have hives over 3 months are unable to find the root problem. We usually check a CU index or antibodies against their own mast cells with ige receptors. Usual treatments involve using H1 receptor antagonist such as fexofenadine or levocetirizine.  Singulair can be added as a secondary agent. Rentless itching and painful rashes candictate a skin biopsy to see if there is a neutrophilic infiltrate. If so a patient may have to consider immune modulators such as cyclosporin ,dapsone or plaquinil.

If you suffer from hives and rashes – please come by my office for a consultation.  We have the tools at our disposal to isolate your allergy trigger and ease your symptoms so you can get a good night’s sleep and have an improved quality of life.

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