Persistent Skin Itching and Redness: Possible Causes and Treatments

Itchy and red skin?

Hello Doctor: My mother has been seeing a dermatologist for nearly a month and has received injections, but there has been no improvement; she is still itching.
She is seventy years old, and some doctors say it is eczema while others say it is urticaria, but nothing has worked.
She is still red and itchy, and her skin is even peeling.
Isn't it supposed to get better with medication? Why hasn't she improved? Could there be other underlying conditions?
Now the doctor has drawn blood and tested her urine.
One hospital indicated liver issues and drew more blood to check for gastrointestinal problems, while another hospital said her condition is serious and recommended hospitalization for observation.
What is going on? Could skin issues lead to other problems? Or is it simply that the treatment has not been effective?
What I am worried about is whether her skin problems indicate issues with other organs or if there are other skin conditions present.
The symptoms of redness, swelling, itching, and peeling have not improved with antihistamines and topical treatments.
Could there be other underlying issues? Please let me know, as the doctors have only told us that hospitalization is necessary and that her condition is serious, but they haven't provided further information.
Thank you.

Fangzi, 40~49 year old female. Ask Date: 2005/01/31

Dr. Jiang Zheen reply Dermatology

Your description is insufficient for me to make a medical judgment.
The physical condition of the elderly tends to fluctuate more significantly, and during winter, changes can occur at any time due to weather conditions.
It would be better to discuss this further with the current physician to better understand the situation.
Wishing you safety and well-being.

Reply Date: 2005/01/31

More Info

Persistent skin itching and redness can be distressing, especially for elderly patients like your mother. Given the complexity of skin conditions and the variability in responses to treatment, it’s understandable that you are seeking clarity on her situation.
From your description, it appears that your mother has been experiencing symptoms that could be attributed to several dermatological conditions, including eczema (dermatitis) and urticaria (hives). Both conditions can cause significant itching, redness, and skin peeling. However, the persistence of her symptoms despite treatment raises concerns about the underlying cause.

Possible Causes
1. Eczema (Dermatitis): This is a chronic condition characterized by inflamed, itchy skin. It can be triggered by allergens, irritants, or stress. In older adults, it may also be exacerbated by dry skin or underlying health issues.

2. Urticaria (Hives): This condition results from an allergic reaction and presents as raised, itchy welts on the skin. It can be acute or chronic, and in some cases, the cause may remain unidentified.

3. Other Skin Conditions: Conditions such as psoriasis, fungal infections, or even contact dermatitis could also be responsible for her symptoms.
4. Systemic Issues: The fact that her blood tests indicated potential liver issues and gastrointestinal concerns suggests that there may be systemic factors contributing to her skin problems. Liver dysfunction can lead to skin changes, including itching and rashes, due to the accumulation of toxins in the body.

Why Treatment May Not Be Effective
1. Misdiagnosis: If the underlying condition is not accurately diagnosed, the treatments prescribed may not be effective. For instance, if the issue is primarily systemic rather than localized to the skin, topical treatments may not yield results.

2. Inadequate Treatment: Some conditions require specific treatments that go beyond antihistamines or topical steroids. For example, if there is an underlying infection or a need for immunosuppressive therapy, standard treatments may not suffice.

3. Chronic Nature: Chronic skin conditions can be resistant to treatment and may require a multi-faceted approach, including lifestyle changes, dietary adjustments, and possibly more aggressive medical interventions.

Next Steps
1. Comprehensive Evaluation: It’s crucial for your mother to undergo a thorough evaluation by a dermatologist who can assess her skin condition in conjunction with her overall health. This may include patch testing for allergies or a biopsy if necessary.

2. Addressing Systemic Issues: If liver or gastrointestinal problems are suspected, it’s essential to work with a healthcare provider to address these issues, as they may be contributing to her skin symptoms.

3. Holistic Approach: Consider a holistic approach that includes not just medication, but also lifestyle changes such as dietary modifications, stress management techniques, and proper skin care routines to help manage her symptoms.

4. Follow-Up: Regular follow-ups with her healthcare providers are essential to monitor her condition and adjust treatment plans as needed.

Conclusion
Skin issues can often be a reflection of broader health concerns, especially in older adults. It’s important to ensure that your mother receives a comprehensive evaluation that considers both her skin symptoms and her overall health. Persistent itching and redness should not be ignored, as they can significantly impact quality of life. By working closely with healthcare professionals, you can help ensure that she receives the appropriate care and support needed to manage her condition effectively.

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