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20 years
Hi. Whenever i go to sleep, i get several itchy redness areas on my skin like my hands, back, belly and sometimes my legs. And it sometimes happens when i get sweat. What could it be? How to treat it?
Aug 31, 2014
2nd opinion

Dr. Zakia Dimassi Pediatrics
Urticaria refers to a group of disorders in which red patches and wheals appear on the skin; a wheal is a swelling of the surface skin. The skin swelling occurs under the influence of the release of certain chemicals such as histamine, from specific cells in the skin. As a result, small blood vessels dilate (they increase in diameter) and leak. The wheals can be a few millimetres or several centimetres in diameter, usually red in color, often surrounded by a red flare, and frequently itchy. Each wheal may last a few minutes or several hours, and may change shape. Wheals may assume different shapes: round, rings, map-like patterns, or giant patches.
What you have is a physical intermittent type of urticaria, which could be due to:
- allergy against food or medication,
- a collateral manifestation to some infections,
- cholinergic urticaria: results from sweating. In severe cases, hundreds of tiny red itchy spots develop after running, when warm, or when concentrating
- Contact urticaria results from absorption of a substance through the skin or through a mucous membrane that may be allergic or non-allergic in origin. Whealing may ensue, and it could be restricted to the site of contact or spreading more widely. Substances that could elicit such reactions include chemicals in white flour, cosmetics, and textiles, or to proteins in latex rubber, saliva, meat, fish and vegetables. Non-allergic examples include the stinging reaction of certain plants (e.g. nettles), animals (hairy caterpillar) and medicines.
- Localized heat urticaria, aquagenic urticaria (water contact), solar urticaria (sunlight) are less common.
Routine tests to diagnose the cause of urticarial may be needed and include:
In most cases of urticaria, there is no need for specific investigations. However, the following tests may be helpful in some cases.
 Full blood count to identify elevated eosinophil count (these are a special type of white blood cells that are elevated upon allergic reaction) caused by allergy or parasitic infestation
 Skin prick testing and blood tests for specific allergy
The choice of treatment is based upon on the type of urticaria, its severity and duration. If a medicine is suspected to be the cause, it should be stopped.
Oral antihistamines (Zyrtec, Aerius etc.) control whealing and itching for the majority of patients with urticaria. However, they do not affect the underlying cause of the rash. They may need to be taken on and off or continuously until the underlying tendency to urticaria disappears. Most people eventually recover.
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