DEAR DR. GOTT:
Thank you so much for you column. My mother and I live 1200 miles apart and both read it daily in our newspapers. We have learned so much from you — especially the bar of soap trick, what a lifesaver!

I’d like to ask your thoughts about recurrent, chronic hives. I’ve suffered from this problem for several months. I itch, I scratch, and then I get welts. They generally disappear in a half hour or so but pop up again somewhere else. It happens two-eight times a day, every day. Antihistamines help but do not totally get rid of the symptoms. I recently took a six-week trip from Florida to Nova Scotia, thinking all during the trip that the complete change of food and atmosphere would help the hives if they were from an allergic response. They kept on coming, daily, during the trip, just as they do at home.

My allergist has tested for me foods, chemicals and inhalants. I am allergic to some trees and grasses but when I have the hives I do not have respiratory symptoms. My dermatologist drew an X on my back with his fingernail, but no hives resulted. The welts do not appear if there’s no itch first. A blood test only revealed that I have a rather high eosinophil count (19% in the last test).

I’ve spent hundreds of dollars on tests and doctors, with no conclusive results. Based on reading I’ve done, I think this is idiopathic and I may just have to learn to live with it but I don’t recall ever seeing chronic hives discussed in your column. Any thoughts or ideas you have would be helpful, not only to me but to many others as well.

DEAR READER:
Chronic, recurring hives can be very difficult to treat. The problem is often compounded by the fact that almost half of all cases are idiopathic, meaning they have no known cause.

Your elevated eosinophil count is telling. These specialized white blood cells are usually only active during certain allergic diseases, infections (primarily parasitic), and in the presence of certain medications. Allergic disease can include asthma, eczema, hay fever, and autoimmune disorders. Medications include amphetamines, certain psyllium laxatives, certain antibiotics, interferon and tranquilizers.

Most chronic hives occur daily (as yours do) but last for several hours. Hives also tend to itch only after developing. Because yours do not appear until after itching and scratching, your dermatologist correctly performed a pressure test. This test using a blunt point and in individuals with delayed pressure urticaria (hives), the area drawn on will develop welts. This may occur within minutes but may take several hours before they are obvious. Again, however, you are atypical with welts only appears after scratching. I am tempted to say that you have a strange combination of delayed pressure urticaria and eczema (an area of dry skin that itches then rashes after scratching); however, I am not a dermatologist.

I urge you to seek out second opinions from a dermatologist and allergist. They may be able to provide new insight and order new testing. Because your symptoms are chronic, recurring and clearly affecting your quality of life, I recommend you visit the dermatology and/or allergy clinics of a teaching hospital. I note that you live in Florida. You are in luck because there is a specialty resource known as The Mayo Clinic located in Jacksonville, FL. You may also wish to check out some of the universities near you to see if any offer clinics at area hospitals where medical students and professors see the general public. This is a great option because you will be getting excellent care and aiding in a student’s education.

In the meantime, I recommend you take antihistamines as a preventive to reduce your symptoms.

To give you related information, I am sending you a copy of my Health Report “Allergies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.