Conversation: The conversation between human and AI assistant.
[|Human|] Hi,My husband is 28yrs old.. He started with itching on his forearm & top of hand about a week ago and then followed tiny bumps you couldn t see unless you really looked closely..Shortly after his chest,arms,legs,tops of feet,and hands were covered in what looks like a rash of some sort.. His hands are the worst.. He has tiny bumps that are filled with clear fluid and come in groups or single spots.. He says they do not hurt just feels really gross.. I have had scabies before and they look NOTHING like that.. We went to the ER today and the doctor told him it looks like a food allergy and prescribed him prednisone and atarex .. I m not sure he is happy with the diagnosis so I am trying to get a second opinion
[|AI|]  Hello, It is not common to develop a food allergy at this age although not impossible. If the rashes he had developed were definitely after eating a specific food (which must happen every time) then a diagnosis of rash secondary to food allergy is plausible. What you describe is something like cholinergic urticaria, a form of urticaria (this is not allergy in >80% of cases) that is triggered by temperature changes and mast cell release of mediators like histamine. Scabies is also a possibility that is intensely itchy and needs to be excluded with a careful examination, skin scrapings or a course of treatment if there is high clinical suspicion. Atarax is a strong antihistamine (sedative, so take at night) and prednisolone must be stopped after 5 days giving Atari a chance to work. You can switch to non-sedative antihistamines like fexofenadine or cetirizine. There is no blood test for a definitive diagnosis but thyroid disease or diabetes need to be excluded along with a complete blood count to ensure there is no infectious trigger. Hope that helps.