Foot, Leg, Waist Rash

Last week I went to the OB/GYN and he started me on 4,000 IU of Vitamin D and Provera.  I began taking them Friday and Monday evening I experienced a blotchy leg rash - itchy and hundreds of bumps on my feet and legs.  I called the ER as my mother has had two life-threatening allergic reactions.  The ER told me (over the phone) that they were certain I had Cold-Induced Uticaria.  However, Tuesday when I skipped my Vitamin D dose, the bumps were better (not gone, but better).  Wednesday, I took the Vitamin D and again broke out (really badly this time - still all lower than belly button).  I called my doctor's office - they said the same thing - Uticaria - and said to do nothing because the bumps would go away when I got warmed up (had been outside minimally).  However, a couple hours later the bumps were getting more intense, many more of them, hot feeling (not to touch), and itchy.  I caved and took the Benadryl.  Overnight, the bumps went down in swelling slightly; however, they turned a very deep purply-red color.  This evening, again, the bumps increased in size and itchiness.  I again caved and took Benadryl (first dose since last night).

Any thoughts?  It sure does not seem like Uticaria as the bumps do not go away.  Could it be a Vitamin D allergy (or fish oil allergy) and if so, how long before it will be out of my system?  Last dose was yesterday morning (9:00) of 4,000 IU.  

Thank you!

[Bhupinder Kaur, MD]

Hello,
The symptoms are suggestive of hives or urticaria. Many cases of hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections or medications and it can be vitamin D in your case.

Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. You can apply some calamine lotion at the rash as it will help in soothing the skin. You can take some OTC oral antihistamine medications like Benadryl or Claritin and see if it helps.

For mild-moderate symptoms a weak steroid may be used , whilst more severe cases require a higher-potency steroid. But they are available under prescription and should be taken only after consulting a dermatologist. Symptoms  can be exacerbated by dryness of the skin. Use good quality moisturizers to prevent moisture loss from the skin.

I sincerely hope it helps. Take care and please do keep us posted on how you are doing. Warm regards.