Sunday, March 7, 2010

Doctor, I looked like Dr. Dolittle!

I hear this complaint at least weekly in my practice. Patients come in with horror stories & pictures of their lips, eyes or ears kept swelling to the point that they looked like Eddie Murphy's character in Dr. Dolittle. So what's going on?

Most commonly, they are having an allergic reaction called angioedema. Angioedema is a transient, non-pitting, localized swelling of the subcutaneous (just beneath the skin) or mucosal tissues.

This is most commonly from:
- food (kids- eggs, milk, peanut, and adults- tree nuts, peanut, shellfish, and fish)
- drugs (most commonly ACE inhibitors (blood pressure medication), aspirin, or ibuprofren), or
-environmental allergens (air born allergens like pollens).

What does that mean? basically, hives form on areas of the thin skin allowing an watery (exudative) like fluid to fill the space. Because the skin is thin, it easily swells and grows in size leading to the Dr. Dolittle look. You might also experience nausea, abdominal paint, hypotention, and itchy eyes.

Up to 15% of the population will experience an episode of angioedema. There are other genetic and aquired conditions that cause angioedema, but these are much rarer than an allergic reaction.

If you have an episode of angioedema, take an antihistamine (like benadryl) and seek medical help. You should be evaluated by an allergist/immunologist to determine the specific cause.

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