Skin Rashes and Non-Allergic Causes

Recently I saw a number of skin rashes of the hands and feet and legs that were not caused by allergy but due to infestation by mites. Mites can be transferred from human to human or from pets to human.

Itchy rashes can be caused by parasites and fungal infestation. Each of these have their particular manifestation. Psoriasis can be at times itchy. So is a very particular skin condition called dermatitis herpetiformis which is extremely itchy.

So remember, not all itchy skin rashes are caused by allergy and therefore a diagnosis is not always straightforward.

And my learning continues...

Allergy in Piety

I had an interesting case of a middle age Malay lady who came to see me because of an extremely itchy thickened lesions at both of her knees and some parts of her ankle. My investigative skills were challenged, but I finally solved it.

Turns out, her allergy was due to her prayer mat which she use to kneel and the cause of the allergy was due to the new detergent she uses to wash her mat. Asking her to revert back to her old detergent solved her problem.

You never know where allergy can pop up!

My learning continues....

Rubber Allergy

Many years ago, one of my dance instructors showed me her feet - it was scaly around her toes and sole.

"Aha", my first thought was a fungal infection, but tests showed it was not. Muscle testing revealed that she was sensitive to rubber products, particularly her socks. She was wearing '100% cotton' socks but since it was stretchable, I was sure it had rubber components in it. She cleverly went to hunt for a pair of socks that did not have rubber but was made of cotton spandex and simply enough, her allergy was cured.

The big problem of rubber allergy is when the rash is at your undergarment areas such as your bra region. Boxer shorts help but even that some still gets the rash and i have advised for these to go back to the 'good-old-days' undies that my dad used i.e. those which you need to tie with strings and these are specially sown. Not especially cool or fashionable, but it will help tremendously in the long run.

Lesson: The simple key to contact-based allergy is avoidance.

My learning continues...

The Extremes of Allergies

An allergy can present as two extreme manifestations; I had two cases today to demonstrate my point.

One young man came to see me for a patch of thickened skin rash at the back of his neck, about the size of a ten-cent coin. He was diagnosed to have chromium allergy (i.e. allergy to chrome). It was due to a chain he was wearing for some time, a gift from his girlfriend.

The other patient had seen me 5 years ago and was diagnosed as having egg allergy and has actually got well after treatment by me. This time, he had a scaly rash all over his scalp, his face and his whole body. His condition is known as exfoliative dermatitis, a severe allergic reaction. His present severe manifestation is in contrast with what he experienced 5 years ago - only a mild skin rash. This illustrates the unpredictability of allergy.

I can remember some other cases I've had of extreme allergic manifestations.

Many years ago, one patient of mine had an allergy to yellow dye additive (as found in certain foods) and was admitted to a hospital for an anaphylactic reaction (i.e. allergic shock) in Sydney after taking some butter for breakfast. After that incident, she kept an Epipen (Epinephrine Auto-Injector) with her. She had another attack in Kuala Lumpur when she was back in Malaysia but after I prescribed her with probiotic, she has never had another attack since. 

Another patient is the daughter of a squash buddy of mine who had peanut-induced anaphylactic shock, which can cause death very rapidly, like 5 minutes. He brought her to see me, and after treatment, she has not had an attack since.

Allergy can range from the very mild to very life treatening

My learning continues...