Age: 30.0
Sex: F
Vaccine: FLU4
Symptoms: Decreased activity, Pain, Pruritus, Urticaria
Clinical narrative: 11/15/2020: Hives were first discovered on stomach, arms, and legs at 5:00 am. Immediately took Benadryl 25 mg tablet. I have no allergies and have never experienced an adverse reaction to vaccines, medications, food, or health care products (such as lotion, body wash, etc.).   11/15/2020-11/16/2020: Within the first 6-12 hours, the hives began to spread to my entire body. I took one dose of Benadryl about every 4-6 hours for the first 24 hours, starting at 5:00 am when the hives were discovered on 11/15/2020. Benadryl did not provide relief. I also used calamine lotion on affected areas for the first 24 hours to calm itching.   11/16/2020: I visited my dermatologist (who I have visited before for acne but no other skin issues) at 3:15 pm who confirmed hives but could not confirm the specific cause. I provided information on the vaccine that I received (as that was the only ?new thing? that I had taken or began using  within the last few months). He instructed me to keep a detailed journal and monitor flare-ups, as well as change detergent, not use fragrances (in health care products or home products, such as Glade Plug-ins), and monitor foods that commonly cause reactions in individuals (such as strawberries). He prescribed Triamcinolone 0.1% Cream. I was also instructed to take Zyrtec 10 mg instead of Benadryl (since I was seeing no relief). He also provided the option to take Pepcid 20 mg with the Zyrtec. I began using Triamcinolone 0.1% Cream on patches of hives that night at around 6:00 pm and took a Claritin 10 mg tablet with the Pepcid 20 mg.   11/15/2020-11/17/2020: Hives covered extremities and most of body the first 48 hours after discovery. They were large patches (about 8-10 inches grouped together) and were painful, itchy welts. They moved frequently around my body and would disappear and reappear in different areas every 1-2 hours. I noticed that the hives would flare sporadically and appear in unusual places (such as tops of feet and neck), but specifically on ?touch points? (example: sitting on the couch or in the car would cause large welts on my back, butt, back of legs, and back of arms). I limited showers and would only use cool water with Aveeno fragrance-free body wash. I also kept my skin moisturized with Aveeno and CeraVe, and wore loose clothing. No pain relievers such as Advil or Tylenol were taken.  11/17/2020: Continued use of Triamcinolone 0.1% Cream and Claritin 10 mg with Pepcid 20 mg.  11/18/2020: Discontinued Triamcinolone 0.1% Cream (hives were frequently moving and I did not want to continue reapplying cream if the hives disappeared and reappeared in the same area); I also saw no relief from the cream since I began using it. I saw a good amount of improvement that morning from the Claritin and Pepcid taken over the last 48 hours; the patches were still present but they no longer covered my entire body.   11/18/2020-Present: I have continued to take Claritin 10 mg. On 12/2/2020 I discontinued the Pepcid 20 mg as it specifies on box not to take for more than 14 days. The hives have not gone away permanently, but they have improved since 11/18/2020. They continue to appear on my stomach, arms, legs, back, and butt, either in large patches or small spots that are grouped somewhat close together. It is rare that they appear on multiple areas of my body, but it has happened (for example: the night of 12/8/2020, they were on my arms, back, and butt after sitting on the couch for a few minutes). I work from home due to COVID and do not typically notice any hives during the day while I work at my desk and move around, but I tend to wake up with them in one or two areas and go to sleep with them in one or two areas. To be on the safe side, I have changed to a fragrance-free detergent and I continue to use fragrance-free body products. I have tried to keep somewhat of a detailed journal with photographs, and have found no correlation between the hives/flare ups and any food or products that I have used. I have had no other symptoms or health issues since first discovering them on 11/15/2020. I have also not taken any pain relievers, such as Advil or Tylenol, since discovering them. I'm a fairly active person but have not exercised or exerted myself much since discovering them; I only go on short walks when the weather is cool (I do not see flareups from the walks).