Q: When I wash my face and hands in the morning for the first time, my palms itch, look red and then pain. The problem goes away after a few minutes and no rash is observed. This again happens while taking a bath in cold water. Earlier this used to happen more frequently in winter and my ears, legs also used to itch when I would come out in cold weather. I had taken levocetrizine hydrochloride tablets for 2 months but the problem recurred whenever the medicine was stopped. Later, I had taken injection Histaglobulin six times as prescribed. The problem then seemed to be cured. After two months the problem is again showing up. I had consulted a number of dermatologists but now it seems the problem was only temporarily cured. Recently one doctor said the problem is probably not a skin problem but a case of peripheral neuritis. Can you please advise me what I should do now? Is there a permanent cure for such problem? I should mention, for the last two years I had taken vitamin capsules daily (capsule becosule) but have stopped it now. If it is due to that, what should I do? I also took famotidine tablets for few years but that too is stopped. I do not take alcoholic drinks, don't smoke and am otherwise healthy. Please advise.

A:My diagnosis goes like this (in descending order): 1. Aquadynia : Where contact with water is followed by intense, widespread burning pain that lasts for 15 to 45 minutes. It appears to be an extension of the phenomenon of aquagenic pruritus, it could respond to clonidine or propranolol. 2. You could be suffering from Aquagenic pruritus, in which contact with water induces itching without visible lesions. 3. Aquagenic urticaria which is a rare condition in which hives develop within 1 to 15 minutes after contact with water. The hives last for 10 to 120 minutes and do not seem to be caused by histamine release like the other physical hives. Most investigators believe that this condition is actually exquisite skin sensitivity to additives in the water such as chlorine. It is diagnosed by applying tap water and distilled water to the skin and observing the reaction. It appears in response to water at both cold temperatures and hot temperatures; when exposed to tap water at room temperature. It is treated with a cream called capsaicin (Zostrix) that is applied to the irritated skin. Antihistamines are of questionable benefit since histamine is not the causative factor in water urticaria. Conditions resembling aquadynia are aquagenic pruritus and urticaria, hysteria or simulation, Fabry's disease, erythermalgia, peripheral neuropathy or polycythemia vera. Please go to the nearest & the most reputed dermatologist/neurologist in your area now that you have a few words to play with maybe they can act on this lead and help you.