How should I proceed

43 female non diabetic non htn c/c -itching followed by swelling for last 1 month. 12days back Rx given : inj avil I'm stat inj dexona IV stat then took deflazacort 6 mg tds for 5 days followed by 6mg bd for 5 days.but since 2may night she developed these lesion again and from 1st may she is on defalz 6mg od dose. today I gave her hydrocortisone 100 mg and avil ink IM and t.dexona bdpc. during lockdown she is unable to go higher center. S.IgE and DLC somehow she managed to send the sample.reports awaited. in morning OPD she came with these lesion again.during initial medication it was controlled. she has lower back joint problem for last 10 years. how should I proceed ??

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Find out cause like food,medicines or infection, insect bite and internal diseases. Common foods that may cause are nuts, chocolates, fish, tomatoes, eggs, fresh berries and milk. Fermented foods ,strawberries to avoid. Antihistamines and steroids to be continued Desensitization of allergens after allergy test to be done
Palpabral chr urticaria It may be allergic Or idiopathic At present start tab dispred4mg 1tds Tab fexofenadine180mg 1od Tab ranitidine 150mg 1bd Deworming Local application of atarax lotion or calosoft AF lotion Investigate her for routine investigations Cbc AEC IgE bsl f&pp Lady seems to be fatty and obese hence r/o hypothyroidism Inj histaglobe 1vial /sc weekly for 2months and tapper off gradually
Thanx dr Pushkar ji Bhomia
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Chr urticaria Needs further investigation into evaluation to conclude and find out cause.. Inj avil 2cc + ini dexona 2cc I'm SOS. Dewarming. Covid 20 mg in morning od. Levocet 5mg bd. Tapering dose of steroid orally. Clean area with diluted betadine lotion apply caladryl lotion locally. Avoid oily , spicy and fast food. Find out allergy to food ,medicine, cloths and thyroid and renal profile.
Thanks Dr Kute Ankush
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Acute ( <6 weeks ) urticaria. Get a detailed history. If there is any provoking factor , stop it. 1.food items ( even the preservatives) 2.Drugs ( even the coloring agent ) 3. LFT 4. RFT 5. CBC ,ESR. Empirical management. 1. Tab Fexofenadine 180 mg morning. 2. Tab Levocetrizine 5 mg HS 3. Tab Cyproheptadine 4mg afternoon. 4.Ranitidine 150 mg bid. Steroid SOS.
Tab Atarax25-BDPC 5 days. Tab Famtac 40- BDAC 10 days. Cap Golbi SR450- OD 1 month. Lactocalamine lotion- apply locally TDPC 7 day's. Careful when the rashes occur look for causative agent,it may be food or something else ( Take note all- for precipitating factors). Adv: blood for FBG PPBG TSH LFT urea Cr. Allergy profile test.
Thank you sir.what is the significance of lft and cr.in this casr
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IT'S A..CASE OF.. ? HIVES.. URTICARIA.. ? DERMATOGRAPHISM .. ? ALLERGIC RASH.. * BILASTINE OD.. * DFL..WITH TAPERING DOSE SCHEDULE.. * PPI..OD.. SOS.. * DEWORMING WITH ALBENDAZOLE AND IVERMECTIN.. * INVESTIGATIONS..SOS.. CBC.. HBA1C.. IgE .. ALLERGIC STUDY..
Tnx Dr Ashok Leel sir
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Recurring urticaria Till Lockdown you give her Tab Medrol 8 mg bd Tab Allegra 120 mg bd After that you send for Allergy test after results of reports get her desesitize
Thank you sir
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Urticaria find out the cause May be drugs or food.
Urticarial rash Drug rash
I agree
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Chronic urticaria Drug / food allergy to be excluded . Cholinergic urticaria ,due to increased body warmth due to tight clothing or intense exertion to be excluded. Antihistamines, monteleucast, low dose steroids suggested . Allergen identification and exclusion. Auto hemotherapy is one option .
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