Unknown cause of urticaria with doctors not knowing what to do

[maitmc]

21F, in 2022 I started developing urticaria around springtime and it progressively got worse, with it eventually being almost everywhere except my face and head but now mostly relegated to my crotch and shoulder. I had severe hives on the inside of my thighs and shoulder, inside of my elbows and armpits. Nothing on my crotch, it's just itchy. I went to my original primary caregiver to get tested for allergies but it turns out I have none, and the antihistamine and ceterezine they prescribed didn't work. The antihistamine I bought over the counter sometimes work, but not often. I switched to another caregiver since the original one was unprofessional and just went "urticaria sometimes has an unknown cause" and left it at that. New doctor referred me to a dermatologist, dermatologist didn't accept my insurance and I don't have enough money to pay out of pocket. My original thought was that my liver was producing too much bile and that was causing my urticaria but I have no other symptoms of liver failure.  I believed that my liver was damaged, so I ended up cutting food from my diet: first being processed foods like ham (I don't eat dessert so that got covered), then all meat, green tea, and nuts, then any food that required baking/frying. I also started drinking dandelion tea, shiso, and eating a lot of mung beans, which showed some result and the majority of my itching has subsided in the daytime. I have both synthetic and cotton underwear, I shower every two days, wipe down everyday and change clothing daily. Eventually I went to the emergency room several days ago because my crotch was itching badly, got tested for yeast infections, STIs, pregnancy (despite never been sexually active), all three came back negative, and they couldn't figure out what was wrong with the vagina. I have no off-color discharge nor does it smell, I don't have constipation either and my bowel movements are fine. Almost every night, I wake up at least twice because I'm itchy, back when it was really bad, I would wake up 5-6 times. Nowadays I wake up at around midnight, then go to sleep, then wake up at 3 and I keep on itching until around 11-12. I used antihistamines as stated, hydrocortisone, and eczema relief skin protectant lotion, and the results are inconsistent. Using bar soap to wash my crotch doesn't have any effect on my itching, so I have been using Phisoderm Fragrance Free cream cleanser, which limits the itching. Wipes make my crotch itch more, and hot water sometimes makes it worse. I only have two ideas now, being either an autoimmune issue or psychosomatic. Does anyone have any idea on what to do now? My doctor's appointment always takes 4-5 months and the ones I've seen so far haven't been able to help me. Thank you.

[GuitarRox]

Gosh, I'll say this. You are very smart and articulate. That has to be so uncomfortable. This is just me but there are dermatolotists that may take your insurance. Or if you self pay, it goes to the yearly deductible. But that is what I think you need to do. (assuming you also get regular gynecological exams and they've also weighed in). I keep thinking ezcema. Have you tried an oatmeal bath? While psychosomatic things can happen, this doesn't sound like that. Just my opinion. By the way, one often overlooked thing that can cause chronic itch in the vagina is hormonal changes. This is why a gyn is good to consult with. Lichen planus, lichen simplex, or lichen sclerosus can cause chronic itch. These are inflammatory disorders. I'd keep going to discover what this is. A dermatologist would be excellent. Save up and go. It could be worth getting over this.

[maitmc]

Thank you, I'm trying to find a dermatologist right now that will accept my insurance, and no I don't have a gynecologist, although making an appointment with one would be wise, thank you for tat idea. I haven't tried an oatmeal bath yet, so I'll update on that aspect.

[maitmc]

I also forgot to mention, after reading about it, lichen planus seems to fit the majority of my symptoms, at the beginning of the chronic urticaria, the corners of my mouth was swelling and cracked pretty heavily.