Dr. Summit Shah
There is no cure for immunodeficiency disorders. The goal of treatment is to control infections and maintain the patient’s quality of life. Infections are treated with antibiotics, which are sometimes taken on a regular schedule for preventive treatment. Patients with low antibody levels may be given injections of immunoglobulins (antibodies) to increase antibody levels.
A drug allergy is an allergic reaction that occurs when the body’s immune system produces antibodies and activates disease-fighting cells in response to a specific drug. In the development of a drug allergy, the immune system is triggered by the first exposure to the medication. A future exposure causes an immune response, including the production of allergic antibodies and release of histamine. So, drug allergy reactions occur after a person has been previously exposed to the drug one or more times without any allergic reaction.
There is no specific test for eczema. The diagnosis when done by an allergist is based on skin appearance and on personal and family history.
Aggravating factors may include:
- Exposure to environmental allergens
- Exposure to food allergens, especially in infants
- Temperature changes
- Clothing materials such as wool and synthetic fibers
Everyone reacts to medications differently. One person may develop a rash, while another person on the same drug may have no adverse reaction. All medications have the potential to cause side effects, but only about 5% to 10% of adverse reactions to drugs are allergic. Reactions to medications can range from mild to life threatening.
The location of eczema on the body changes with age. In infants and young children, the cheeks, neck, knees and elbows are typically affected. In older children and adults, the hands, feet and areas inside the elbows and knees may be affected.
Symptoms may also include:
- Dry, leathery, scaly skin
- Intense itching
- Blisters with oozing and crusting
- Raw areas of the skin from scratching
- Skin color changes
- Skin redness or inflammation
Fortunately, at long last, we now have the ability to test for penicillin and penicillin derivatives through a simple skin test. If the history and testing align, the diagnosis is confirmed in about 97% of cases. Diagnosis of other drug allergies is done mostly through a patient’s medical history. Allergists are specifically trained for this.
Eczema, or atopic dermatitis, is a chronic allergic skin condition mainly affecting infants and children. It often begins within the first year of life, with 60% of cases occurring by age 1 and up to 90% of cases by age 5. It may last until adolescence or adulthood. If eczema is diagnosed in adulthood, it is generally a long-term or recurring condition. Fifty percent to 75% of patients with eczema may eventually develop hay fever and/or asthma.
The main feature of eczema is itchy, dry skin that scales and flakes. Often, there is a personal or family history of eczema, hay fever, hives, food allergies or asthma. When skin itchiness is not controlled, an “itch/scratch cycle” leads to continued rubbing and scratching and subsequent thickening of the skin called lichenification.
Drug rashes are the body’s reaction to certain medications. The type of rash that occurs depends on the type of drug that is causing it. Rashes can range from mild to severe.
Rarely, drug rashes may result in blisters. These blisters can be a sign of a more serious condition, so they require medical attention.
Avoidance of the allergen is the best treatment. If it is caused by a medication, strict avoidance is necessary.
Allergists may recommend antihistamines to decrease histamine release, which can lessen the symptoms of hives and/or angioedema. They may be prescribed on a regular schedule to prevent symptoms. Chronic hives may be treated with antihistamines or a combination of medications. For severe hives and angioedema, an injection of epinephrine may be needed.