Friday, August 9, 2019

Surprises and Chronic Autoimmune Urticaria

Last week, as I was floating in my hammock chair I saw something amazing: a perfect spider web that seemed to be suspended mid air.

So beautiful. How on earth did the spider architect anchor it? The connecting silk lines were almost invisible.

What arachnid artistry.

I snapped pictures of it from all angles.

This photo didn't turn out as well.....kindly disregard the hammock hair. 

What a pleasant surprise. I love those kind of surprises.

Then there's the other kind of surprises. I'm not happy with that kind.

Like this one:

Yeah. That's my old lady knee. Notice the strange red rash? Before I slathered hydrocortisone cream on it and took an antihistamine, it was in full-blown puffy hives mode. There were lots of them. On both legs. Accompanied by a vicious itch.

Not fun.

So these hive beauties have been showing up every night for the last few weeks; only to disappear promptly by 9:00 AM. And for the life of me, I just can't figure out why. I have changed nothing in my night time routine. I've used the same unscented laundry detergent for years, my jammies are literally decades old, and the sheets on our bed have been around forever. I use the same body wash, sunscreen, and moisturizers for what seems like forever.

My environment has been the same for a whole year, and I've been eating the same foods too.

So what's causing this very unwelcome and extremely strange change in my skin?

I have no idea.

The only thing that HAS changed is the absence of immune suppressing drugs in my body for the last six weeks. 

Is this related? Could hives be caused by an increase in autoimmune activity? I wondered.

After a bit of Google Scholar reading, the short answer is possibly yes. The long answers can be found here. Here's an excerpt:
Chronic urticaria is hypothesized to occur because of a predilection in the patient to develop reactions to self. Supporting this hypothesis, a strong association has been found between chronic urticaria and additional autoimmune diseases, such as thyroid disease, rheumatoid arthritis, systemic lupus erythematosus, Sj√∂gren’s syndrome, celiac disease and type 1 diabetes, among others. (Bolding mine) Continue reading here
It appears that Sjogren's syndrome can possibly cause hives like mine, also known as chronic autoimmune urticaria. Dr. Young Guy and I will be discussing this soon to try to determine the cause of my particular brand of hives.

Good grief. Is there any part of my body that ISN'T affected by autoimmune disease? 

Have you experienced chronic autoimmune urticaria?


Sue said...

I have 3 red splotches on my lower left leg that look a lot like hives but they have been around since sometime last Sunday night. We went kayaking after Mass last Sunday and everything seemed fine when I went to bed but I woke up to find some nasty red marks. It is always on my left leg too, I seldom get a rash on my right leg. Not itchy at all and starting to look less angry so perhaps they will go away but I am going for a dinner time paddle tomorrow, we will see if it happens again. I had a hat, sunscreen, and my kayak skirt on so who knows. Sjogren's is a royal pain.

Have a good weekend

annie said...

I will occasionally have small urticaria, sometimes on legs, but mostly on arms, sometimes they're itchy and sometimes not.

I do suffer from seasonal allergies for which I take appropriate meds for, also mine are usually small pimple like urticaria. I did have a full blown all over the body huge urticaria one year, many years ago and before being diagnosed with sjogren's. They lasted over a week and I had to be put on prednisone. I had that on my arms, legs and all over my torso. It was very scary not knowing what caused it.

I think autoimmune illness makes us very reactive. When I went for allergy testing, My allergist found reactions where I should not have had any.He said I had very reactive and sensitive skin.

Julia, it could just also be you are so sensitive to something in the air, trees, sun while you're out at that particular time of the day. Also being off your meds could be atrributed? Who knows? I wishyou great strenghth in this other battle.

Kelly said...

In a word, yes. I've had hives consistently for over a year although they are getting less frequent and less prominent. Do you also have Dermatographia along with your hives? I have a picture of the same area above my knee says, "ITCH" in a bright red wheal. I am able to draw pictures or write messages on my skin at will with medium pressure from any blunt pointed instrument like a knitting needle or embossing stylus. It's would all be very amusing if it didn't itch enough to drive me crazy. Since I've been told I don't have an autoimmune condition my hives haven't been labeled the same way as yours, but they are just as mysterious.

Also, like Sue, I have had a condition on my lower legs that sounds eerily similar to what she has experienced. This rash on my lower legs was another mystery until I sleuthed it out myself when a doctor I showed it to made a throwaway comment, "Looks like vasculitis to me." But it didn't fit the pattern of standard vasculitis which is generally worse in cold weather while mine only occurred during hot weather, generally after exercise. There were other dissimilar features that led me to keep researching until I discovered Exercise-Induced Vasculitis, aka Golfer's Rash and Disneyland Rash. It is apparently not uncommon, but also apparently practically unheard of in standard medical practice as I paraded it around for years and never got an answer until I researched it myself.

My ankles and lower legs will swell when this rash occurs and I'd never linked the two situations before since my ankles will also swell when I don't have the rash under certain conditions. But they ALWAYS swell when the rash is present. So it turns out that this sort of vasculitis can sometimes be prevented by wearing compression garments when exercising in hot conditions. Or simply by avoiding exercise when the temperature rises above your given threshold. Mine is about eighty degrees. I've bought some compression sleeves for runners that cover from my ankle to just below the knee to wear during vigorous exercise in the heat. I've not had a bad flare of this condition since I started wearing these every time I play tennis or hike when the temperature is above 80 degrees. Using the footless compression sleeve allows me to wear my usual socks and shoes for any given activity. I also will wear knee-high compression hosiery with sandals if I am going to be doing a lot of walking or sitting in hot conditions when wearing street clothes and not doing vigorous exercise requiring shoes and socks. Since this rash will last weeks once it sets in, an ounce of prevention with compression garments is the ticket for me!

Unknown said...

I've had autoimmune urticaria for far longer than I've been diagnosed with an autoimmune disease. The immunologist was able to tell me the hives were autoimmune mediated but unable to tell me what autoimmune disease was causing them. After nearly 15 years of chronic, daily hives I was diagnosed with my first autoimmune disease. Taking antihistamines that hit all 3 histamine receptors (Xyzal, Zantac, Singulair) got mine under control. Starting on a TNFi (I have ankylosing spondylitis too) helped a great deal, it allowed me to cut the Singulair completely, and the Xyzal to 1x daily, (I still take Zantac 2x daily though). But if I miss even one dose of either of these antihistamines the hives break through with a vengeance. I find that Benadryl spray works well to immediately shut down any particularly bothersome spots. Xolair has been approved for chronic urticaria if you have an elevated IgE. It's a once a month injection that has to be done at a doctors office. I have not tried it, but apparently it works quite well to control chronic hives. Things that make mine worse are heat, sun, pressure (tight clothing), stress of course (insert an eye roll), and pollen (although based on allergy testing I'm not allergic to any food or pollen). Hopefully Dr. Young Guy will have some answers that will provide you with some relief. Until then spay those little buggers with some Benadryl to let them know who's boss. I hope you're feeling better soon.

Anonymous said...

This happened to me several years ago and has not come back. (thank goodness)
I took an antihistamine and it would go away. The pill would usually last a few days to prevent recurrence. After about 6 months, I realized it stopped happening.
Another mysterious Sjogren's malady.

Rositta said...

Yes, right now my body is covered with these splotches and they don’t go away in the morning. I’ve had them since mid July. My rheumi doc says it’s psoriasis and since I have psoriatic arthritis no big surprise. Especially since Remicade was discontinued. All the creams and potions have not worked thus far and even my head is affected. Normally she would prescribe prednisone but because I also currently have a drug caused liver problem that needs sorting I can’t take that just now. So I itch and scratch.

RayMTL said...

The last two weeks I have been getting a red rash on my chest/neck with small pimple-like bumps. Not many, only a couple at a time and both the rash and pimple resolve quickly after the attack. My concern is that during the attack I get an intense prickling feeling that affects my chest and arms and sometimes into my ankles. Seems to be started by exercise but has recently happened when at rest. Does not seem to happen during sleep when you would expect it to. Strange?