[26M] Experiencing unexplained hives with no clear trigger

Patient Description

A 26-year-old male has been experiencing unexplained hives for the past 10 days. The hives are raised, red, and itchy, and they appear randomly around the body, including the legs, arms, feet, torso, and back. The severity and location of the hives change daily, and they seem to be worse in the morning, sometimes occurring after eating a meal. The patient has tried a gluten-free diet but saw no improvement. The patient takes Claritin daily with no noticeable improvement and reports occasional headaches. There is no known history of food allergies, but there is a family history of celiac disease. The patient also has a personal history of vitiligo, diagnosed 3 years ago. No recent travel, contact with anyone with similar symptoms, or changes in medication have been reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Chronic Urticaria: This is a condition where hives or welts appear on the skin, disappear, and then may appear again. The hives can be red, itchy, and raised. They can appear anywhere on the body and can last for more than six weeks, often without a known cause.

    • Treatment typically involves antihistamines to reduce itching. If these are not effective, other medications may be prescribed by a doctor.
  • Food Allergies: Given that your symptoms seem to worsen after eating at restaurants, it's possible that you're experiencing an allergic reaction to a certain food or ingredient.

    • Treatment involves avoiding the food or ingredient causing the reaction. An allergist can perform tests to identify specific food allergies.
  • Contact Dermatitis: This is a skin reaction resulting from exposure to allergens or irritants. It can cause a rash, itching, or blisters. However, it would typically be localized to areas in contact with the allergen, which seems less likely in your case given the widespread nature of your hives.

    • Treatment involves avoiding the irritant or allergen, and creams or ointments to reduce symptoms.

Please note that these are possibilities based on the information provided and not a definitive diagnosis.

What you can do

While waiting for a consultation with a healthcare professional, here are some things you can do:

  1. Keep a food diary: Note what you eat and when you eat it, along with when your symptoms occur. This may help identify potential food triggers.
  2. Try over-the-counter antihistamines: You mentioned taking Claritin, but there are others you could try, such as Zyrtec or Benadryl. Please follow the instructions on the packaging and consult a pharmacist if needed.
  3. Apply a cool, damp cloth to the affected areas: This may help soothe the skin and reduce itching.
  4. Avoid scratching: This can worsen your symptoms and increase the risk of infection.

What you should look out for

Please seek immediate medical attention if:

  • Your symptoms worsen or do not improve after two weeks of self-care.
  • You experience difficulty breathing, swelling of the face or lips, or severe skin pain.
  • You develop other symptoms such as fever, joint pain, or unexplained weight loss.

Remember, it's important to consult with a healthcare professional for a proper diagnosis and treatment.

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1 yr ago

People Also Ask


What are the common causes of chronic urticaria?

Chronic urticaria can be caused by a variety of factors, including autoimmune disorders, infections, stress, and certain medications. In many cases, the exact cause is unknown, which is referred to as idiopathic urticaria.


How can I identify if I have a food allergy causing my hives?

To identify a food allergy, you can keep a detailed food diary to track what you eat and when symptoms occur. An allergist can perform skin prick tests or blood tests to identify specific food allergies.


What are the differences between chronic urticaria and contact dermatitis?

Chronic urticaria involves widespread hives that can appear anywhere on the body and last for more than six weeks, often without a known cause. Contact dermatitis, on the other hand, is a localized skin reaction to an allergen or irritant, typically affecting areas in direct contact with the substance.


What are some effective treatments for managing hives?

Effective treatments for managing hives include antihistamines like Claritin, Zyrtec, or Benadryl to reduce itching. If these are not effective, a doctor may prescribe stronger medications. Applying cool compresses and avoiding known triggers can also help manage symptoms.


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