Dr. Rockoff received his undergraduate degree from Yeshiva College with the distinction of Summa Cum Laude. He received his medical degree from the Albert Einstein College of Medicine. His internship and two years of Pediatric residency were at the Bronx Municipal Hospital Center, followed by training in Dermatology at the combined residency program at Tufts and Boston Universities. Dr. Rockoff is certified by both the American Board of Dermatology and the American Board of Pediatrics.
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Hives fall into two categories: acute urticaria (ordinary hives which resolve after
six to eight weeks) and chronic urticaria (which continue longer than six to
eight weeks).
Ordinary urticaria (ordinary hives)
What are symptoms and signs of ordinary hives?
Ordinary hives flare up suddenly and usually for no specific reason. Welts
appear, often in several places. They flare, itch, swell, and go away in a
matter of minutes to hours, only to appear elsewhere. This sequence may go on
from days to weeks. Most episodes of hives last less than six weeks. Although that
cutoff point is arbitrary, hives that last more than six weeks are often called
"chronic."
What are the causes of ordinary hives?
As noted above, many cases of ordinary hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is uncommon for drugs taken continuously for long periods to cause hives or other reactions.) When a medication is implicated as a cause of hives, the drug must be stopped, since no skin or blood test will prove the connection. In most cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not in fact the cause of the hives.
Despite the reputation hives have for being "allergic,"
when there is no obvious connection between something new that a person has been
exposed to and the onset of hives, allergy testing is not usually helpful.
Chronic hives
Chronic hives (defined as lasting six weeks or more) can last from months to years. The evaluation of this condition is difficult and allergy testing and other laboratory tests are rarely useful in such cases. The accurate evaluation of this condition requires the patient to give his or her physician precise information regarding their complete medical history, personal habits, and oral intake. Occasionally it may be necessary to limit specific foods or drugs for a time to observe any affect upon the skin condition. Certain systemic disease and infections may occasionally present in the skin as hives. If there is an inciting cause that can be determined, then specific treatments for that condition ought to be effective, or in the case of food or drug allergy, strict avoidance would be necessary. There are additionally rare forms of chronic urticaria that are produced when the patient makes antibodies against molecules on the surface of their own mast cells. There are tests available to identify this type of hives.
Physical urticaria is a type of chronic urticaria produced by physical
stimuli. By far the most common form is dermographism, which literally means "skin writing." This is an exaggerated form of what happens to anyone when their skin is scratched or rubbed: a red welt appears at the line of the scratch. In dermographism, raised, itchy red welts with adjacent flares appear wherever the skin is scratched or where belts and other articles of clothing rub against the skin, causing mast cells to leak histamine.
Another common form of physically induced hives is called cholinergic urticaria.
This produces hundreds of small, itchy bumps. These occur within 15 minutes of
exercise or physical exertion and are usually gone before a doctor can examine them. This form of hives happens more often in young people.
Other forms of physical hives are much less common. Triggers for these include cold, water, and sunlight.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Eczema, also known as dermatitis, is a general term for many types of skin inflammation. The most common form of eczema is atopic dermatitis. The other forms of eczema include: contact eczema, seborrheic eczema, Nummular eczema, Neurodermatitis, stasis dermatitis, and dyshidrotic eczema. Symptoms, diagnosis, and treatment of eczema may vary from person to person and may depend on the type of eczema.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Eczema is a general term for many types dermatitis (skin inflammation). Atopic dermatitis is the most common of the many types of eczema. Other types of eczema include: contact eczema, allergic contact eczema, seborrheic eczema, nummular eczema, stasis dermatitis, and. dyshidrotic eczema.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Anaphylaxis is a serious allergic reaction that affects a number of different areas of the body at one time, and can be fatal. Causes of anaphylaxis can be food allergy, latex allergy, allergy to insect or but stings/bites, asthma, or other materials or conditions. Symptoms include flushing, itching, hives, anxiety, rapid or irregular pulse. Severe symptoms may be throat and tongue swelling, swallowing, and difficulty breathing. Some disorders appear similar to anaphylaxis such as fainting, panic attacks, blood clots in the lungs, heart attacks, and septic shock. If you think that you may be having an anaphylactic reaction, seek emergency care or call 911 immedately.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
Drug allergies are cause when the immune system mistakenly creates an immune response to a medication. Symptoms of a drug allergic reaction include hives, rash, itchy skin or eyes, dizziness, nausea, diarrhea, fainting and anxiety. The most common drug allergy is penicillin. Treatment may involve antihistamines or corticosteroids. An Epipen may be used for life-threatening anaphylactic symptoms.
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