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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience:  Emergency Medicine Physician
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I started out with mild hives tiny white blistres on the palms

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I started out with mild hives tiny white blistres on the palms of my hands. after 2 days they became blood red swollen,hives with intense itching. the tops of my hands had tiny bumps but did not bother me. I thought it might be related to cat claw the plant I was trimming back. the itching & swelling & redness started on my soles. both places are very red edematous itchy. they blanch very well, but there are spots of different size red areas. I am on a methylprednisolone dose pack for 4days now, 4mg with tapering doses & it hasn't done anything. any advice?

911DOC :

Are you taking anything besides predisone?

911DOC :

Also, do you have any other symptoms such as fever or joint pain?

911DOC :

standing by

911DOC :

are you there?

Customer:

synthroid,olmeprazole, valium5mg daily asa flexeril. no fever, no joint pain other then what I have already had from osteoartritis

911DOC :

okay

911DOC :

so can you tell me please the starting dose of prednisone that you were taking?

911DOC :

and what dose you are tking now?

Customer:

methylprednisolone 4mg tapering doses started with 6 doses on thurs. on myfourth day 3 tablets today

911DOC :

okay. so for a reaction such as you have had that may be a little low on the dosing but one other thing I noticed is that you are not taking any antihistamine which would be absolutely essential in knocking this down and keeping it knocked down.

911DOC :

no benadryl? no hydroxyzine?

911DOC :

are you there?

Customer:

sorry , Benadryl, & atarax about every 3-4hrs. it is the only thing that helps with the discomfort, some of the redness disappers & swelling but the soles & palms become mottled & red That is the only time I am partially feeling ok. such a small window before I have to load up on 50- 75 mg Benadryl or 20 mg of atarax.

911DOC :

how long has this been going on now?

Customer:

about 7 -8 days, it started off mild & thought it was the cat claw plant because of all the little stickers, 2nd day worse by tuesdy it was a full blown palm dermatitis, the soles of my feet got involved about tues. that is puzzling to me . can it become systemic?

911DOC :

it's puzzling to me as well. one thing I would wonder about it is you may have some of the stickers still in your skin. this would explain your failure to get better sooner.

911DOC :

though it does sound

911DOC :

like this is an allergic reaction to something, be it the plant or something else

911DOC :

but you are at 8 days of symptoms now

911DOC :

and have been treated properly but are not better

911DOC :

it is definitely time to see your physician again and ask about either an allergy referral or, perhaps, a dermatology referral

911DOC :

the steroid dose may be a bit low

911DOC :

they do go low on the pred-pak

911DOC :

so that my be one thing to try

911DOC :

but you are really on all the right medicines and this is a puzzle

911DOC :

so it's time for your doctor to either do some further investigation

911DOC :

or get you to an allergist

911DOC :

it may also be that a dose of epinephrine would be in order to see if this resolves your issue

911DOC :

but that would, of course, be up to your physician

911DOC :

standing by

Customer:

I think the sticker s might be part of the problem. ! think I need a higher dose of steroids, I will see the m.d. how would epinephrine help?

911DOC :

epinephrine is given for severe allergic reactions that are life threatening

911DOC :

if there is any doubt that this is allergic it might help diagnostically

911DOC :

and it might help your body to switch from inflammaory response to a more normal state

911DOC :

just a thought

911DOC :

I too think there may be part of the plant still embedded in the skin

911DOC :

that's a tough one

911DOC :

but will not persist forever

911DOC :

it will take some time but it should work itself out

911DOC :

standing by

911DOC :

are you thre?

911DOC :

'there?

Customer:

thanks I am very obsessive when it comes to something like this . I appreciate your help & advice. I hope my hands & feet don't fall off .

911DOC :

they won't, lol...

911DOC :

do you have any final questions for me?

Customer:

no.

911DOC :

very well

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