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Month: July 2015

Summer Itch or Rash?

Outdoor activities in the summer can result in skin irritation and itching due to a variety of causes.

  1. PAPULAR URTICARIA:  It is an excessive skin reaction to insect bites.  Crops of itchy, red bumps usually less than a half-inch in diameter appear over the exposed areas of the body.  They sometimes progress into fluid filled blisters grouped together.  Scratching them may lead to crusting and/or infected pustules.  The lesions usually last for days to weeks.  Despite the name urticaria, they are not hives, which are raised wheals usually resolving in hours.  The most common insects causing these reactions are mosquitoes, gnats, fleas, etc.  Treatments like topical corticosteroids to lessen the inflammation and oral antihistamines to relieve the itching can be helpful. Application of insect repellants to exposed areas before outdoor activities may help prevent the problem.
  2. CONTACT DERMATITIS:  Skin exposure to the urushiol oil from the leaves of plants like poison ivy, poison oak, and poison sumac can cause severe redness, blistering, and burning sensation in sensitized individuals.  About 60-80% of individuals exposed to the urushiol oil become sensitized to it.  The condition usually begins 24-36 hours after exposure and can last a few weeks.  The lesions cannot be spread to other areas of the body through scratching or oozing of the blister fluid.  Because it can be a severe reaction, many patients will need corticosteroids by mouth for about a week to 10 days to control the condition.  Wearing long sleeves and pants, in addition to application of barrier creams before outdoor activities can be helpful in warding off the reaction in susceptible people.
  3. MILIARIA:  Prickly heat manifests as tiny red or pink spots over the face, neck, upper back, chest, etc.  This condition is caused by clogged up sweat pores which results in retention of excessive sweat which then leads to irritation and itching.  Friction caused by clothing can aggravate the problem.  This condition can be alleviated by using prickly heat powders, calamine lotion, staying in a cool environment, keeping the affected area clean and dry, and taking frequent cool and light baths or showers.  Occasionally, topical corticosteroids are necessary to provide relief.
  4. SUNBURN:  Prolonged exposure to the sun can cause red, irritated, burned, and/or itchy skin which can progress to blistering and open sores over the affected area.  Application of ice compresses and aloe gel can soothe the involved skin.  Avoiding excessive sun exposure, liberal use of sun block creams, and hydrating the skin with consumption of good quantities of clear liquids can be helpful.
  5. XEROSIS:  Xerosis is the medical term for abnormally dry skin.  Though excessive dryness is more common during the winter, prolonged exposure to air conditioned environments with little humidity can lead to dry and dehydrated skin.  Frequent bathing or showering and the use of strong soaps can remove essential skin oils causing the skin to be dry and itchy.  Applying a moisturizer thoroughly all over the skin immediately after a bath or shower will help in seal in the moisture and keep the water from evaporating, leaving the skin cool and moist.

The board certified allergists and trained staff at Black & Kletz Allergy in the Washington, DC, Northern Virginia, and Maryland metropolitan area can answer your questions and concerns regarding many skin conditions and will provide time tested and scientifically validated advice.  Our allergists specialize in both adult and pediatric patients.  We have 3 convenient office locations which all offer on-site parking.  Our offices are located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  The Washington, DC and McLean, VA offices are also Metro accessible.  Please click Request an Appointment and we will answer you within 24 hours on the next business day.  For faster service, please call our office directly.  Black & Kletz Allergy prides itself in providing prompt quality care to the community in a caring professional setting.

Can a Cough Be Due to Allergies?

There are many cause of a cough.  Coughing is usually caused by a viral upper respiratory infection (URI), asthma, post-nasal drip, and/or gastroesophageal reflux disease (GERD).  There are however many other conditions which may cause a cough, some of which include other infectious types of upper respiratory infections (i.e., bacterial, fungal, parasitic), occult sinus infection, vocal cord dysfunction, cystic fibrosis, laryngopharyngeal reflux, pneumonia, bronchitis, bronchiectasis, pertussis (whooping cough), croup, foreign body (which can get stuck in one’s airways), pulmonary embolism, neurogenic cough, post-infectious cough, hypersensitivity pneumonitis, sarcoidosis, psychogenic cough (due to a habit or tic), Tourette’s Syndrome, aspiration, cigarette smoking, chronic obstructive pulmonary disease (COPD) (i.e., chronic bronchitis, and/or emphysema), interstitial lung disease, tumors, congestive heart failure, exposure to air pollutants, and the side effects of certain medications such as angiotensin-converting enzyme inhibitors [(i.e., lisinopril (Zestril, Prinivil), enalapril (Vasotec), ramipril (Altace), benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), quinapril (Accupril), trandolapril (Mavik), moexipril (Univasc), and perindopril (Aceon)].

So can allergies play a role in causing a cough?  Yes.  Since asthma is a leading cause of cough and about 80% of individuals with asthma also have allergies, one can see right away that allergies play a large role in causing a cough.  In addition, there is a sub-group of asthmatics who have a condition called cough-variant asthma where sufferers only cough as a result of their asthma.  They do not have the accompanying wheezing, shortness of breath or chest tightness that most other asthmatics experience.  As if this wasn’t bad enough, it is estimated that 75-80% of asthmatics have gastroesophageal reflux disease (GERD), which is also one of the most common causes of a cough.  Allergies also play a major role in predisposing a person to develop a sinus infection (sinusitis) which again often causes a cough.  Immunodeficiency disorders (which are diagnosed and treated by allergists/immunologists) such as hypogammaglobulinemia also predispose people with these disorders to acute sinus infections.  Hypersensitivity pneumonitis is a condition where there is an inflammation of the air sacs (alveoli) of the lungs caused by an allergic reaction to inhaled antigens such as dusts, molds, and chemicals.  Individuals with this condition commonly have certain hobbies and/or occupations that expose them to these antigens.  Once again, cough is a primary symptom of this disease.

In individuals with a persistent cough, many tests can be done in order to diagnose the reason behind the cough.  Some of these tests include blood work, chest X-rays, CT scans of the chest and/or sinuses, allergy testing, pulmonary function tests (PFT’s; breathing tests), rhinoscopy, upper endoscopy (with or without biopsy), esophageal manometry (assesses the function of the lower esophageal sphincter and esophagus), barium swallow, pH monitoring (measures the acidity in the stomach), and bronchoscopy (with or without lung biopsy).  In most cases, the workup usually does not require the last six tests listed above which are generally reserved for difficult cases.  After diagnosing the problem, there are a variety of medications that can be used to treat an individual’s cough.

The board certified allergists at Black & Kletz Allergy have been diagnosing the underlying conditions of coughs and treating individuals with coughs for more than 50 years in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We treat both adult and pediatric patients and have 3 convenient locations in the DC metro area.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA) and Manassas, VA, each with on-site parking.  The Washington, DC and McLean, VA offices are Metro accessible.  Black and Kletz Allergy is committed to providing excellent allergy, asthma, and immunology care to the greater Washington, DC and Northern Virginia community.