Chronic Urticaria: When to See a Family Medicine Specialist

Q: Chronic Urticaria: When to See a Family Medicine Specialist

Dear Mr. Anonymous： 1. The small nodules you mentioned can have many possible causes; the more common ones include folliculitis, sebaceous gland inflammation, lymphadenitis, fibromas, and lipomas, among others. Of course, there are also other rare causes.

Which department to see?

Hello doctor...
I started experiencing全身癢 (itchiness all over) in early January and visited a dermatologist who diagnosed me with chronic urticaria (chronic hives).
Last week, I noticed a small, soft lump inside my cheek, just below the earlobe.
It is not protruding from the skin and is about 0.1 to 0.2 cm in size.
It is painful when pressed.
What could this be? Which specialist should I see? Thank you for your help.

Niming, 30~39 year old female. Ask Date: 2020/03/06

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Anonymous:
1.
The small nodules you mentioned can have many possible causes; the more common ones include folliculitis, sebaceous gland inflammation, lymphadenitis, fibromas, and lipomas, among others.
Of course, there are also other rare causes.

2.
Please discuss this with your primary care physician first, as they may be able to address it; you can also directly visit a dermatology clinic for evaluation.

Reply Date: 2020/03/06

More Info

Chronic urticaria, commonly known as chronic hives, is a condition characterized by the presence of itchy welts or hives that can persist for six weeks or longer. It can be triggered by various factors, including allergens, stress, infections, and even certain medications. Given your symptoms and the recent developments with the lump near your ear, it’s important to approach this situation with a comprehensive understanding of both chronic urticaria and the potential implications of the new lump.

Firstly, regarding the chronic urticaria, it is essential to identify the underlying cause, as this can significantly influence treatment options. In many cases, the exact cause remains unknown, which can be frustrating for patients. Treatment typically involves antihistamines to alleviate itching and reduce the severity of hives. In more severe cases, doctors may prescribe corticosteroids or other immunomodulatory therapies. It is advisable to keep a diary of your symptoms, noting any potential triggers, as this can help your healthcare provider in diagnosing and managing your condition effectively.

Now, concerning the lump you described near your ear, it is crucial to have it evaluated by a healthcare professional. The lump could be a variety of things, including a sebaceous cyst, a lymph node, or even a benign tumor. Given that it is soft and painful upon pressure, it could be an inflamed lymph node, which may indicate an underlying infection or inflammatory process.
For both your chronic urticaria and the lump, I recommend starting with a visit to a family medicine specialist or a primary care physician. They can conduct a thorough examination and take a detailed medical history. They may also perform necessary tests, such as blood tests or imaging studies, to assess the lump further. If needed, they can refer you to a dermatologist for your chronic urticaria or an ear, nose, and throat (ENT) specialist for the lump, depending on their findings.

In summary, it is essential to address both your chronic urticaria and the new lump in a timely manner. A family medicine specialist can provide a comprehensive evaluation and guide you through the necessary steps for diagnosis and treatment. Keeping track of your symptoms and any changes in your condition will be beneficial in your consultations. Remember, early intervention can lead to better management of your symptoms and overall health.

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