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I have a sudden burning sensation that begins in my ears,

then travels to the rest...
I have a sudden burning sensation that begins in my ears, then travels to the rest of my body. It burns and feels prickly. After a few minutes of the burning sensation, my entire body, from face to arms and legs, turns bright, strawberry red with some white splotches. I stay red for 30 minutes to an hour. This happened twice in one day last week, then nothing for a few days and tonight while watching tv, it began again. My skin feels almost sunburned.
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Answered in 3 minutes by:
6/17/2012
dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4,136
Experience: 30 years practice in general and cosmetic dermatology
Verified
dermdoc19 :

These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.

dermdoc19 :

Good evening

dermdoc19 :

Do you take Niacin ( Vitamin B3) by any chance?

Customer:

I do, but it has never caused this type of flushing before....and I took it this morning...hours ago.


dermdoc19 :

That sort of reaction is common with Vitamin B# ***** I agree it usually comes on about 1/2 hour after ingestion.

dermdoc19 :

You should check your blood pressure at these times of flushing.

dermdoc19 :

There are some conditions that can cause this and you should be evaluated by a physician to determine whether you have them.

dermdoc19 :

You might have a pheochromocytoma which would cause flushing and an increase in blood pressure. The increase in blood pressure is episodic.

dermdoc19 :

Carcinoid tumors whic can be benign and malignant. However, most people also have sweating, tremulousness, diarrhea besides flushing if this is present.

Customer:

I have had diarrhea the past couple of days.

dermdoc19 :

This, of course, may be nothing more than menopause, but there is a simple urine ( or blood test) for this called an HIAA ( Hydroxy Indole Acetic Acid)

dermdoc19 :

Any wheezing or respiratory problems or skin rashes?

Customer:

I have been through menopause already...so I don't think it is that. No wheezing or repiratory problems. During the episode, my skin almost feels rash like....very hot, radiating heat. After it passed though, the skin no longer appeared rashlike.

dermdoc19 :

Next time this happens you should have your blood pressure checked to be sure it is not a pheochromocytoma.

dermdoc19 :

I am also assuming you are not on any medications since some can do this.

Customer:

I take thyroid medication...armour thyroid. I also take citalipram and occasionally albuterol for asthma.

dermdoc19 :

There is a huge list of drugs that cause flushing.

dermdoc19 :

I know Albuterol can

dermdoc19 :

I will look up the other one for you.

Customer:

Those are the only three I am on. I have taken all of them for years, so I don't think they would suddenly cause this symptom, would they?


Customer:

I haven't taken any albuterol today or for several days.


dermdoc19 :

Celexa can too.

dermdoc19 :

Drugs can start to do funny things so I would definitely not rule that out.

dermdoc19 :

In the carcinoid syndrome, stress seems to provoke the flushing.

dermdoc19 :

I should mention too that there may be a general thermoregulatory problem. I had a patient some years ago in which a work up for the factors I have mentioned was negative. I referred her to a neurologist who evaluated her and concluded that she had a thermoregulatory problem. She was placed on Clonidine and did quite well.

dermdoc19 :

I have to leave now, so unless you have more questions, I will save and exit. This will keep the system in the CHAT mode, so it will still be easy for you to get back to me.

Customer:
Customer:

Hello, I am a customer service representative posting on behalf of the customer who is unable to view the chat. Please click on the 'Switch to Q&A' link at the top of the page to change the format of the page from Live Chat to Q&A so that the customer can access your reply and also please repost your reply as a new answer or info request. Thank you.


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Evidently you had trouble reading my answers last night. Are they clear now? Please let me know lf you have any questions.
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Do you have further questions? Would you be able to provide any other symptoms? Would you like advice on how I would recommend your physician proceed?
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Customer reply replied 6 years ago

Hi. The customer service rep misunderstood me. I was able to see your answers, but the system was not allowing me to reply. Yes, I would like advice on how you would recommend my physician proceed and also whether I should see my regular GP, or a specialist of some type.

Thanks so much,

Shelly

Thank you. I will give you a run down after office hours.
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Customer reply replied 6 years ago

Still waiting for a response....

Sorry, I wanted to retrieve my notes from a lecture I gave on this subject... but last night I left them at my office.
There are some things that can cause flushing that are not serious. For instance food additives such as Monosodium glutamate ( MSG), Sodium Nitrite in cured meats such as hot dogs, salami etc. ( these are usually associated with a headache, and sulfites ( usually associated with wheezing.)
There is neurologic flushing such as found with menopause, spinal cord injuries, brain tumors, migraines and Parkinson's. Unlikely you have any of these.
As I mentioned earlier there are a number of medications that can cause flushing Essentially any medication which dilates the blood vessels.
If all that has been ruled out your physician should start a workup to rule out
1) Carcinoid Syndrome: as mentioned above. This can be done with a 24 hour urine for HIAA ( Hydroxy Indole Acetic Acid)
2) Mastocytosis; Blood histamine level This is from an excess of mast cells either diffuse or from a tumor. Mast cells are a normal cell which releases histamine. This will be quite elevated with any form of mastocytosis.
3) Pheochromocytoma: blood pressure checked sporadically. VMA level in blood.
After this work up: if negative then you should be evaluated for conditions which are even more rare.
These would include
Medullary carcinoma of the thyroid
Rare benign pancreatic tumos ( eg. VIPomas)
Renal Cell Carcinoma
If all this is evaluated and you still have flushing and wish it treated I would suggest two medications:
Clonidine or Nadolol
Avoidance of hot liquids is more important than avoidance of caffeine.
With alcohol, the problem is not just the alcohol but tyramine which is in some beverages such as sherry, or beer.
Curiously, if you tie this in with mushrooms and beer you can develop flushing.
That really sums up my notes.
I would be happy to answer further questions or clarify any of the above. Please get back to me with any ideas.
dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4,136
Experience: 30 years practice in general and cosmetic dermatology
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