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Painful red rashes in hands, feet during STRESS.

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I have a good friend who since his late 30's has had a strange red rash that shows up every time he is stressed, run down or sick. It shows up in the same places usually, His hands and feet become very red, his neck and around his face. It looks like a rash but he says its not really sore or itchy, except his feet get extremely sensitive during this time, it usually lasts about a week and then the skin on his hands and feet will peal off. Once his feet were in such pain he went to the hospital, they jacked him up with a bunch of anti inflammatory medication and antihistamine, this helped with the pain. We are just trying to figure out what it is and why it keeps coming back in the same exact places, the hospital didn't really have an explanation and we can figure out what is causing it, there isn't anything that he has done out of the norm when this happens. Any advice would be greatly appreciated. Thank you so much for reading and helping :-)

Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
 27 Doctors Online

Thank you for your query at
Will it be possible for you to upload a picture of the rash?
Because what you describe is unique, and i need to see the rash in order to comment.
It can be an urticarial reaction, due to over activation of mast cells, triggered by certain situations.
Kindly upload the picture,

Patient replied :

The rash has gone away now, so I cant photograph it anymore. I would say its flat, not raised, very red solid patches as it goes away it turns white in the middle and a red ring will be in the shape of the orginal patch just before it goes away. I'm not sure what a "urticarial reaction, due to over activation of mast cells," is. Why did it start happening all of a suddon? and why does it keep comming back now for 5+ years?

Thanks for your reply.

From your history, it seems to be chronic urticaria.
Urticaria is what is commonly referred to as hives.
It can be caused by allergy to food, medications, dust, pollen, animal dander etc.
When our body is exposed to a factor which it is allergic to, it's immune system is activated. Mast cells are a specialised type of immune system cells in our body which bring about an allergic response. Their activation leads to redness, swelling etc seen in allergic skin rashes. This is refererred to as an urticarial reaction in cases of urticaria.
In your friend's case, it follows a set pattern which is also possible in urticaria.

It's important to find out a causative factor in order to bring it under control.

However, it's more important to control the rash whenever your friend gets it. Otherwise it might sometimes progress to involve other parts of the body or might involve the nose and mouth, leading to their swelling, thereby causing breathing and swallowing difficulties.
It's not always possible to resolve the rash with treatment since its an allergy but it's possible to bring the rash under control.

For getting the rash under control, anti histamines like Allegra and Claritin are useful.

Please let me know if you have any queries.

Take care.

Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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