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Saturday, 19 September 2009 00:50 |
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Few things are as annoying as hives. Patients are often desperate from the itch and the accompanying lack of sleep. The medical name for hives is urticaria. Hundreds of things can cause hives and nearly every medicine ever used will lead to someone somewhere getting hive. The most common medicines are the penicillen antibiotics, along with sulfa antibiotics. The opiate family of pain medications, which includes morphine, demerol, and codeine are also major causes of hives. Imagine being in pain and then having the added joy of a new insanely itching rash. That is an unhappy person. Foods can be another cause of hives, and peanuts have become public enemy number one at many schools. Many nuts and berries bring on hives. There are also hives that are from viruses. Instead of getting a cold, your skin may get the reaction.
Hives are an inflammatory reaction in your skin with the release of histamine causing swelling and redness in the skin. The itch gets worse with itching and this can lead to a snowball effect of increasing itching. The most important thing to be aware of is that what is happening in the skin can also affect breathing. ANY challenge with breathing needs to be treated immediately as a medical emergency. Dial 911 and don't take any chances if there is any question about a respiratory emergency. I recently gave Epipens to two patients in one week with severe hives. A man from Tega Cay and a woman from Ballantyne both had reported that they had had minor trouble breathing when their hives began. An Epipen is a dose of adrenaline that is carried for respiratoy emergencies and can be given to help open the airways. If a pen is needed, the next step is getting to an emergency room because the medication does not have a long term effect.
How do I know if it's hives? If it is an itching rash that moves from place to place that's likely what you have. If you scratching your skin and it welts up in the scratch line that's an easy way to confirm. That is a finding called dermatographism- the ability to write on the skin and get it to welt. A small percent of people always have dermatographism and I recently saw a woman from Lake Wylie who has been suffering from this for years. Without daily anti-histamines she has hives from nearly any skin contact.
So if it is hives you have, I hope it doesn't last long and that you aren't suffering too much.
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Wednesday, 26 August 2009 13:32 |
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The dreaded pain and blistering of shingles is a something that few can forget. Shingles and zoster are the same condition. The rash is a reawakening of a dormant chicken pox infection. The case of chicken pox may be decades old or very recent. Most cases of shingles occur in older people, and the odds roughly double every decade you live that you will have theis eruption. As a Charlotte dermatologist I have seen many patients who are just trying to get seen immediately and have been frustrated because they can't be seen, sometimes even at an office they've been to for years. This is an emergency, especially if it is on the face. David Letterman missed three weeks of hosting his show due to a case of shingles on the upper face. The eye can be involved and this can lead to permanent vision impairment. |
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Read more: Shingles and Zoster [Shingles and Zoster]
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Thursday, 20 August 2009 13:00 |
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There are many ways to scar the skin. I have seen chainsaw scars and bullet holes. I've removed shrapnel from men who fought in World War 2. I have seen shark bites and man-o-war stings. I have seen patients who have been butchered going overseas to save a few dollars for their cosmetic procedures and nearly came home dead. But the number one cause of scarring I see is the easily the finger. To be exact, the fingernail. |
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Read more: Fingers, The Ultimate Weapon [Fingers, The Ultimate Weapon]
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Thursday, 20 August 2009 02:24 |
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I had a recent patient from Waxhaw with a rash that had been itching him for days. He was diagnosed with a fungal infection and had been put on an oral anti-fungal which cost him hundreds of dollars. He got more and more lesions by the and then happened to see my ad. This man was in a minor frenzy of itch and was unable to sleep. He estimated that he had 100 lesions on the trunk and I would say 150 having a better look at his back than he had. He had the classic christmas tree rash pattern of pityriasis rosea that few patients develop. Happily the trreatment brought quick relief and the diagnosis reassured him that he wasn't dying from "a flesh eating bacteria". |
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Read more: Pityriasis Rosea [Pityriasis Rosea]
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Thursday, 30 July 2009 20:14 |
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Poison Ivy
| Warm weather and those little leaves are growing. The allergy to poison ivy and oak is so common that nearly half of us will have it. The chemical that we react to is called Uroshiol. It has no color or odor but can lead to weeks of suffering as it is the leading cause of contact dermatitis in America. We often explain contact dermatitis as a poison ivy reaction. One touch and this chemical starts a chain reaction that can lead to itching, blistering, and suffering that few can ever forget. The initial reaction may take two weeks to arrive as we become allergic for the first time, but any exposure after that may happen in only two days. |
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Read more: Poison Ivy [Poison Ivy]
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