Help identifying a reoccurring rash

Could someone help me identify a reoccurring rash for my wife? She has had the symptoms for 2-3 years now. It was appearing on the hands for the first year, but now it seems to have left the hands and has appeared on the face and throat area for about a year and a half.

It comes and goes at random times during the year. Sometimes it's very frequent, appearing on a week by week basis. Sometimes it can take 2 months to first appear, but when it does it comes back straight after disappearing. It isn't season specific.

It tends to appear first thing in the morning upon waking up. It lasts about a week. Day 1, is very deep red and sore. Day 2 redness starts to subside and skin starts to dry/flake. Day 3-7, redness slowly goes and while it does, skin is very dry/flaky itchy.

These pictures are taken on day 2 of the rash appearing:
1) http://dl.dropbox.com/u/228727/rash/dsc05851.jpg
2) http://dl.dropbox.com/u/228727/rash/dsc05852.jpg
3) http://dl.dropbox.com/u/228727/rash/dsc05854.jpg
4) http://dl.dropbox.com/u/228727/rash/dsc06046.jpg

We have researched this and she have tried abstaining from various cosmetics, creams, foods etc... but it hasn't proved to be a long term cure (if it was ever even a cure).

Would you have any ideas what this could be or things she could try?
Thanks for your time.

[Bhupinder Kaur, MD]

Hello,
It can be due to hives. Hives (medically known as urticaria) are red, itchy, raised areas of skin that appear in varying shapes and sizes. They have a tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.

Many cases of hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections or medications. Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. Your wife 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.

If the symptoms persist then you may need topical and oral steroids for which you need to consult a dermatologist.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[leke]

Ah, sorry. Those pictures would be from day 3.

[Bhupinder Kaur, MD]

Hello,
It can be due to hives. Hives (medically known as urticaria) are red, itchy, raised areas of skin that appear in varying shapes and sizes. They have a tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.

Many cases of hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections or medications. Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. Your wife 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.

If the symptoms persist then you may need topical and oral steroids for which you need to consult a dermatologist.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[leke]

Thanks for the response. I think marks do look the most like hives so it gives us more to look into.
I read up on urticaria on wikipedia and it could be related to a autoimmune disorder which is I hear could be linked to her Alopecia universalis disorder.
She seems to think it's still related to consuming products with yeast ie. a yeast allergy, but even though it seems to come less often when she omits things that contain yeast (bread, wine etc...), it still comes. I read in the article it's very unlikely the hives are a result of an allergic reaction.