[22F] Experiencing widespread itching with red bumps

Patient Description

A 22-year-old female presents with widespread itching involving her hands, feet, legs, arms, chest, and back, accompanied by little red bumps on her thighs and legs. These symptoms have persisted for a few days to a week. The patient has a history of cholestasis of pregnancy but is not currently pregnant and has not noticed any recent changes in liver function or gastrointestinal symptoms. She reported a sore throat prior to the onset of itching and has recently lost her appetite. The patient has allergies to seasoning and Clorox, and had an allergic reaction to clindamycin in the past. She is not on any medications and has not been exposed to any new substances that could explain her symptoms. No respiratory distress or angioedema is present, and there are no signs of jaundice.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes of your symptoms include:

  • Allergic Reaction: Given your history of allergies, it's possible that you're experiencing an allergic reaction. This could be due to a new food, medication, or environmental factor. Allergic reactions can cause itching, hives (which might look like little red bumps), and loss of appetite.

    • Treatment typically involves avoiding the allergen and taking antihistamines to help control the itching.

  • Dermatitis: This is inflammation of the skin that can cause itching and redness. There are many types of dermatitis, including contact dermatitis (caused by direct skin contact with something you're allergic to) and atopic dermatitis (also known as eczema, which is often associated with allergies and asthma).

    • Treatment usually involves moisturizing the skin, avoiding irritants, and using medicated creams or ointments.

  • Scabies: This is a skin infestation caused by a tiny mite. It causes intense itching and a rash that can look like small red bumps. The itching is often worse at night.

    • Treatment involves medications that kill the scabies mites and their eggs.

  • Cholestasis: Although you're not currently pregnant, you mentioned that you had cholestasis of pregnancy in the past. Cholestasis can also occur outside of pregnancy, and it causes intense itching without a rash. However, you would likely also have other symptoms such as yellowing of the skin and eyes (jaundice), dark urine, and light-colored stools.

    • Treatment depends on the underlying cause of the cholestasis.

What you can do

  1. Try to identify any new substances you've come into contact with that could be causing an allergic reaction. This could include new foods, medications, or products like soaps or detergents.
  2. Over-the-counter antihistamines can help control itching due to allergies or dermatitis. However, you should check with a healthcare provider before starting any new medication.
  3. Keep your skin moisturized to help reduce itching and irritation.
  4. Avoid scratching as much as possible, as this can worsen the itching and increase your risk of infection.

What you should look out for

You should seek medical attention if:

  • Your symptoms worsen or don't improve after a few days
  • You develop new symptoms such as difficulty breathing, swelling of the face or mouth, or yellowing of the skin or eyes
  • The itching is so severe that it's interfering with your sleep or daily activities

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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9 mo ago

People Also Ask

What are common causes of widespread itching and red bumps on the skin?

Common causes of widespread itching and red bumps include allergic reactions, dermatitis, scabies, and sometimes systemic conditions like liver issues. Identifying the cause often involves considering recent exposures, medical history, and accompanying symptoms.

How can I differentiate between an allergic reaction and dermatitis?

An allergic reaction often presents with sudden onset of itching, hives, and sometimes swelling, usually after exposure to an allergen. Dermatitis, such as contact or atopic dermatitis, typically involves chronic itching and redness, often linked to skin contact with irritants or allergens. A healthcare provider can help differentiate between the two based on history and examination.

What are the symptoms of scabies and how is it treated?

Scabies is characterized by intense itching, especially at night, and a rash that looks like small red bumps or blisters. It is caused by a mite infestation. Treatment involves prescription medications that kill the mites and their eggs, and all close contacts should be treated simultaneously to prevent reinfestation.

Can cholestasis occur outside of pregnancy and what are its symptoms?

Yes, cholestasis can occur outside of pregnancy and is known as intrahepatic cholestasis. Symptoms include intense itching without a rash, jaundice (yellowing of the skin and eyes), dark urine, and pale stools. It requires medical evaluation to determine the underlying cause and appropriate treatment.

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