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Dermatology  (Expert Forum)
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3 different rashes
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

3 different rashes

by kuhnto, Jun 06, 2006 12:00AM
I am a 29 year old male.

Over the past year I have had three strange types of rashes.  The first rash or hive as I call it was first noticed after pressurewashing the house.  It occured on one shoulder and look like a bunch of raised hives, no noticable redness, itchy, 1 inch diameter, and they felt "stiff" when pushed.  I thought they might be a bunch of wasp stings.  I later discovered that I get this hive/swelling/rash anytime I put any long term pressure on my shoulders such as a laptop bag.  They will last a day or two depending on the weight and duration of pressure.  This has also occured on my buttox after sitting on one half for a while or sitting on my wallet on the hard floor.  I will get a big, stiff, red welt which easily felt when walking.

Soon after this, I notice sort of the same thing on the palms of my hands.  Red blotches, usually with clearly defined edges.  These get itchy and last a few days. I notice that this rash occurs when I am doing any physical labor with my hands (Hammering, yard work, etc.) My hands get very stiff. There is no raising of the skin, but the redness looks like it is under the first few layers of skin.  My doctor looked at it and, based of pressing them (They disapear for a second), determined that it was expanded/aggitated blood vessels. The same thing seems to happen to my feet.  They can get itchy, red, with slight swelling.

The third rash/hive I am getting is a small raised, non red area usually in small semi circular clusters or random patterns on my back or sides.  They range from 0.2 inches, to 2 inches.  These are itchy.  After a day, they will get slightly red, and the swelling will go away. After annother day, they will be gone.  I usually will find these after waking up in the morning.  Recently I found that they were grouped right along where my underwear line is.  In this case, I was working most of the day outside and sweating a lot.  Once they all go away, I might have a day or so of being clear, then one might come back.

My doctor did some standard blood tests and the only thing out of range was a high liver enzyme level. This seems to be caused because I am a daily alcohol drinker.  I am to abstain for 6 weeks and retest.  Could this be causing these rashes?

Tom

by Alan Rockoff, MD, Jun 06, 2006 12:00AM
This sounds like dermograpshim ("skin writing"), a form of hives induced when pressure causes mast cells--present in everyone's epidermis--to leak histamine.  This form of hive is physical rather than allergic.  It usually comes for no reason and goes the same way.  I suggest you try over-the-counter Claritin 10 milligrams per day, and set up an appointment with a skin doctor.  See if you can reproduce the symptoms by stroking the skin with an unopened pen--make a design and see if it "light up."  If so, photograph it, or any other of the symptoms you describe, and show it to the skin doctor when you go.  If the Claritin works, that should help show the right approach to suppressing these hives until they go away by themselves.

Take care.

Dr. Rockoff
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