Skin Conditions

Skin conditions can cause symptoms such as redness, itching, swelling, dryness, irritation, or rashes. Skin reactions may be triggered by allergies, irritants, medications, infections, environmental exposures, or underlying immune system conditions.

Some skin rashes are temporary, while others may become chronic and require ongoing treatment. Common allergy-related skin conditions include:

Hives & Angioedema

Hives are raised, itchy welts that can appear anywhere on the body. Angioedema causes deeper swelling beneath the skin, often around the eyes, lips, hands, or throat.

Atopic Dermatitis (Eczema)

Eczema is a chronic skin condition that causes dry, itchy, inflamed skin. Symptoms may flare with allergens, irritants, weather changes, stress, or infections.

Allergic Contact Dermatitis

Allergic contact dermatitis occurs when the skin reacts after contact with a specific allergen or irritant, such as poison ivy, fragrances, metals, soaps, or certain skin care products.

What are the symptoms of Hives?

Hives (urticaria) typically appear as raised, itchy welts or bumps on the skin that may be red, pink, or skin-colored. The welts can vary in size, appear anywhere on the body, and may come and go quickly.

Common symptoms of hives include:

• Itching

• Raised welts or patches on the skin

• Redness or swelling

• Burning or stinging sensations

Angioedema causes deeper swelling beneath the skin and most commonly affects:

• The lips

• Eyelids

• Face or cheeks

• Hands and feet

• Throat

In some cases, swelling can also affect the digestive tract and cause abdominal pain or cramping.

Acute hives usually resolve within a few days or weeks, while chronic hives may continue or recur for months or even years.

How are Hives diagnosed?

Diagnosing hives and angioedema usually begins with a review of your symptoms, medical history, medications, possible triggers, and a physical examination.

In many cases of chronic hives, an exact cause cannot be identified. Chronic hives are often related to underlying inflammation or immune system activity rather than a specific allergy.

Routine blood work or extensive screening tests are not always necessary and may not change treatment recommendations. However, allergy testing may be helpful in certain situations, especially when symptoms appear after eating a specific food, taking a medication, or coming into contact with a known trigger.

Your allergist will determine whether additional testing is appropriate based on your symptoms, history, and pattern of reactions.

What are the symptoms of Eczema?

Eczema symptoms can vary from person to person but commonly include:

• Dry, itchy, or sensitive skin

• Red or inflamed patches of skin

• Rash or irritation

• Cracked or scaly skin

• Oozing or crusting during flare-ups

• Thickened skin from chronic scratching

Eczema can appear in different areas of the body depending on age.

• In infants, eczema commonly appears on the face, cheeks, and scalp.

• In children, the rash often develops in the bends of the elbows, behind the knees, on the wrists, or behind the ears.

• In adolescents and adults, eczema may affect the hands, feet, neck, arms, or behind the knees.

Some patients with inherited skin barrier conditions, including filaggrin gene mutations, may be more prone to chronic dry skin and hand eczema.

How is Eczema diagnosed?

Eczema is typically diagnosed through a review of symptoms, medical history, family history, and a physical examination. In many children, the exact cause of eczema is not always clear, and symptoms may be influenced by a combination of genetics, allergies, environmental triggers, and immune system activity.

Treatment often focuses on protecting the skin barrier, reducing inflammation, and preventing flare-ups. Common treatments may include:

• Daily moisturizers

• Topical steroid medications

• Anti-inflammatory creams or ointments

• Avoidance of known triggers

• Treatment of skin infections when present

In some children, especially infants and young children with moderate to severe eczema, food allergies may contribute to flare-ups. Evaluation by a board-certified allergist can help determine whether allergy testing or additional evaluation is appropriate.

If a food allergy is suspected, your allergist may recommend a supervised elimination diet followed by a medically supervised food challenge to help confirm whether a specific food is contributing to eczema symptoms.

In more complex cases, collaboration with a registered dietitian may also be recommended.

What are the symptoms of allergic contact dermatitis?

Symptoms of allergic contact dermatitis usually develop after the skin comes into contact with a triggering allergen or irritant. Common symptoms may include:

• Red rash or skin irritation

• Itching, which can sometimes be severe

• Dry, cracked, or scaly skin

• Bumps or blisters

• Oozing or crusting skin lesions

• Swelling, burning, or tenderness

Symptoms often appear at the site of contact but may spread to nearby areas of skin. Reactions can range from mild irritation to more significant inflammation depending on the trigger and amount of exposure.

How is allergic contact dermatitis diagnosed?

Diagnosing allergic contact dermatitis begins with a detailed review of your symptoms, medical history, daily activities, and possible exposures. Your allergist may ask about:

• Work or occupational exposures

• Hobbies and recreational activities

• Skin care products or cosmetics

• Fragrances or hair products

• Jewelry or metal exposure

• Soaps, detergents, or household products

A physical examination is also performed to evaluate the appearance and location of the rash.

Patch Testing

Patch testing is commonly used to help identify substances that may be causing allergic contact dermatitis. During testing, small amounts of diluted allergens are placed on the skin, usually on the back, under adhesive patches.

The patches remain in place for approximately 48 hours, and the skin is evaluated over several days to check for delayed allergic reactions.

Patch testing can help identify specific chemicals or substances that should be avoided to help prevent future skin reactions.