[20F] Experiencing severe itchiness, rash, and hives with eye heaviness

Patient Description

A 20-year-old female reports severe itchiness and a rash that began on the neck and has spread to other areas, including the armpits, stomach, and back. The rash on the neck is described as small red dots closely packed together. Accompanying the rash, the patient has developed hives, characterized as raised clear bumps, in the itchy areas. These symptoms have been present for the last couple of hours. The patient has found temporary relief from itchiness using cortisone cream. Additionally, the patient reports feeling fatigued and experiencing difficulty breathing but no swelling of the face or lips, coughing, or wheezing. Recently, the patient also began to experience heaviness in the eyes, making it difficult to open them wide, without any associated pain. This symptom started about 10 minutes ago. The patient has not used any new skin products, medications, or supplements recently and is unsure of any contact with substances that could cause an allergic reaction. There is no known past medical history of similar symptoms, except for a mention of experiencing similar itchiness in the past.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Allergic Reaction: Sudden onset of severe itchiness, hives, and difficulty breathing could be signs of an allergic reaction. This could be due to a variety of triggers such as food, medication, or environmental factors.

    • Treatment typically involves avoiding the allergen and taking antihistamines to help with the itching and hives. In severe cases, epinephrine may be needed.
  • Dermatitis: This is inflammation of the skin that can cause itchiness and a rash. There are several types of dermatitis, including atopic dermatitis (eczema) and contact dermatitis.

    • Treatment usually involves topical creams to help with the inflammation and itchiness.
  • Urticaria: Also known as hives, this is a skin reaction that causes itchy welts. This can be caused by an allergic reaction, but sometimes the cause is unknown.

    • Treatment usually involves antihistamines to help with the itching.

What you can do

  1. Seek immediate medical attention. Difficulty breathing can be a sign of a severe allergic reaction, which can be life-threatening.
  2. If you have an epinephrine auto-injector (EpiPen), use it as directed.
  3. Try to identify any potential triggers for an allergic reaction. This could include new foods, medications, or exposure to certain environments or substances.

What you should look out for

  • If your difficulty breathing worsens or you start to feel lightheaded, seek immediate medical attention.
  • If your symptoms do not improve or worsen after taking antihistamines, seek medical attention.

Remember, while I strive to provide accurate information, I am not a doctor. Please seek care from a healthcare professional for a formal diagnosis and treatment.

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7 mo ago


People Also Ask


What are the common symptoms of an allergic reaction?

Common symptoms of an allergic reaction include itchiness, hives, difficulty breathing, swelling of the face or lips, and sometimes gastrointestinal symptoms like nausea or vomiting. In severe cases, it can lead to anaphylaxis, which is a medical emergency.


How can I differentiate between dermatitis and an allergic reaction?

Dermatitis typically involves inflammation of the skin that can cause itchiness and a rash, often due to contact with an irritant or allergen. An allergic reaction can also cause a rash and itchiness but is often accompanied by systemic symptoms like difficulty breathing or swelling. A healthcare professional can help differentiate between the two based on symptoms and history.


What should I do if I experience difficulty breathing along with a rash?

If you experience difficulty breathing along with a rash, it is important to seek immediate medical attention as it could be a sign of a severe allergic reaction. If you have an epinephrine auto-injector, use it as directed and call emergency services.


Are there any home remedies to relieve itchiness from hives?

To relieve itchiness from hives at home, you can apply cool compresses to the affected areas, take an oatmeal bath, or use over-the-counter antihistamines. It's also important to avoid scratching the hives to prevent further irritation.

1 Comments


Leo#17

6 mo ago

Did you have any success with over-the-counter creams? Once I had a horrible itchy hives-like rash for a week and finally was able to relieve it with an anti-histamine medication (oral). Fortunately never had the hives again and also never found out what caused them, although I did use Head and Shoulders shampoo right before and never did again

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