Allergic Rash " Siri is a 28-year-old elementary school teacher who has been struggling with a rash "

Case study ( 4211 views as of January 26, 2022 )

Siri is a 28-year-old elementary school teacher who has been struggling with a rash that comes and goes over the last two weeks. It came on "out of the blue" after attending a music recital, and was intensely itchy. It looked like red blotches with raised, fleshy plaques that would last for an hour or so, then settle down. Siri tried over-the-counter anti-histamines, which would seem to help for a few hours, but made her very tired, and made her mouth feel very dry.

Siri has had no swelling to her lips, tongue, or the back of her throat, and no trouble with breathing. She hasn't had any recent cold or infectious symptoms. She has no significant allergy history, other than occasional itchy eyes in the springtime. She is not aware of any food allergies or intolerances, but has been wondering if she's developing some kind of a food allergy. She hasn't taken any new medications or supplements.

Siri would benefit from seeing her primary care provider to confirm the nature of the rash, but this sounds like "hives" or "urticaria". Hives are often associated with allergies, but may also occur in the context of viral infections, or reactions to medications. Some people develop hives in the context of exercise, temperature changes, stress, or for no clearly identifiable reason. Given two weeks of symptoms, referral to a skin care specialist, allergist, nutritionist or other allied care provider may assist in identifying a reversible cause for Siri's rash. An emergency department visit may provide some options for symptoms control, and education regarding dangerous allergic symptoms to watch for. A pharmacist will be of assistance in understanding symptom control choices, and any prescription medications Siri may be given.


Conversation based on: Allergic Rash " Siri is a 28-year-old elementary school teacher who has been struggling with a rash "

Allergic Rash " Siri is a 28-year-old elementary school teacher who has been struggling with a rash "

  • Even though she doesn't have a history of food allergy, Siri could try keeping a food record and monitoring if her rash gets worse after eating certain foods. She could try an elimination diet, where she cuts out a food that may be causing the rash for a couple weeks and then re-introduces it. If the rash re-appears, that's a good indication she has developed an allergy/intolerance to the food item.
    • That's very good advise and a good thought on keeping a food diary
  • When experiencing an allergic reaction many people immediately think Benedryl - which can cause dry mouth and fatigue. She would benefit from speaking to her pharmacist about other medication options
  • Several years ago I developed an allergic rash or hives out of the blue. I wasn't able to pinpoint it's cause and in the end the doctor determined that it was likely due to some kind of virus. He mentioned that they don't discover the cause of a very high percentage of allergic rashes
  • How common is it for adults to develop food allergies, as opposed to in childhood? I've read that if it does occur, it's a result of becoming more sensitive to pollen and associated proteins. Regardless, Siri may want to consider having an allergy test done to determine if she should avoid certain foods.
    • My mother got and allergic reaction to shell fish as well late last year. Lasted for two weeks and was painful.
    • My husband developed an allergy to shellfish at 35.
    • At 69 years old my Dad developed an allergy to tomatoes and strawberries. These were 2 foods he has always eaten. The doctor told Dad that our bodies change and can develop allergies at any time.
  • In addition to reviewing her food for possible causes she should also think whether she has introduced any skin care items, soap, laundry products or makeup. She should chart her reactions to see if she can pinpoint the cause
    • An allergy to skin care or laundry detergent is possible. My husband has sensitive skin, therefore we only use certain products when doing the laundry. About a year ago, while using the same laundry soap, my husband developed hives. We thought it may have been diet related as we had attended 2 functions that weekend and had different foods. We continued to watch this and it kept happening. After visiting the doctor and nothing could be found I was speaking to a friend who told me to check the laundry soap. I said I use the same one but infact just opened a new bottle. I called the company to see if anything in the ingredients had changed and it had. We stopped using the soap and the irritation stopped.
    • @K.Michael - this is a valid point. I have had skin reactions to laundry detergent and soap in the past, and the rash certainly mimicked something I thought was an allergic reaction.
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