Q: I am a 44 years old woman having allergy and skin rashes for the last 14 years. I have rashes on the skin with itching on legs and foot. I underwent a test and the result showed immunoglobulin IgE - 305.3 IU/ml, anti- dsDNA (by ELISA) - 168 IU/ml and my chest X-ray report showed - trachea is normally placed, heart size is normal, lungs show increased pulmonary vasculature and peripheral streaky opacities. Both domes of diaphragm are normal. Bony cage is normal. Impression - chronic bronchitis. I am taking xyzal and Zincovit for the last 10 days.

A:The history suggests that you have an allergic tendency, as your IgE is mildly elevated. The treatment you are taking may help but if it does not, you should see a rheumatologist to see if the skin problem, the mild increase in dsDNA can be tied together. Also a skin biopsy of any rash may help. If you do not have cough and phlegm and do not smoke the chest x-ray finding may suggest a more chronic lung process like "hypersensitivity pneumonitis" which can be due to exposure to pet animals, various dusts and many other conditions. Getting a full lung function test with DLCO (diffusing capacity of the lung for carbon monoxide), spirometry and lung volumes and a non-contrast high resolution CT scan of the chest will give more information. It may help to discuss these suggestions with your regular doctor or see a pulmonologist or respiratory specialist. As you know, without a full history and examination this is general advice to help you and your doctor consider the next steps in helping you.