Q: I am 29 years old, 5’ 9” in height and about 65 kg in weight. For the last 8 years or so I am suffering from a skin allergy during the evening associated with an itchy feeling on my back. Whenever I get this allergy, I take cetrizine hydrochloride, which seems to be working for me. I have been taking this medicine for about 2- 3 years now. Besides this I take finastaride daily for hair loss. Now, apart from this problem I suffer from indigestion and feel full even after taking a small amount of any food. Sometimes I feel as if the food is stuck in my throat. Now, for the past few days I feel as if some pressure is being applied on my chest when I lie down. Is there any relationship between my stomach problem and skin allergy? I have always been an active person and now I feel my life has become sedentary. Please help me.

A:You are probably suffering from chronic urticaria and need to be investigated for various aetiological factors, which may be triggering this reaction like: Aetiological factors (Five Is + others): 1. Ingestants: a) Foods - cheese, eggs, nuts, fish, mushrooms, etc. b) Food additives - tartarzine dyes, etc. c) Food preservatives d) Drugs - penicillin, salicylates (Aspirin), sulphonamides (Sulpha antibiotics), etc. 2. Injectants: a) Insect bites b) Injection - drug, sera, blood, etc. 3. Inhalants: - Pollens, animal dander, etc. 4. Infestation by parasites: - Amoebiasis - Giardiasis - Hookworm - Round worm 5. Infection - focus in teeth, tonsils, sinuses or elsewhere. 6. Physical causes/factors (Urticarial attacks are brief lasting for 30 to 60 minutes): a) Dermographism (write-on-skin) - stroking the skin with a blunt metallic instrument results in an exaggerated triple response. b) Pressure urticaria c) Cholinergic urticaria - decrease in core body temperature (small intensely pruritic papules) d) Cold urticaria - cold air or water e) Heat urticaria - heated object f) Solar urticaria - sun exposure g) Exercise induced - urticaria h) Aquagenic pruritus/urticaria - contact with water i) Vibratory urticaria - handling vibratory instruments 7. Contact urticaria - On coming in contact with potato, onion, nitrogen mustard etc, develops urticaria at site of contact. 8. Rule out underlying collagen vascular disorders, malignancy or any psychogenic cause. Consult a dermatologist for a detailed work up and treatment of underlying cause.