<<Is there a role for steroids in the acute phase?>>
NO. Don't work fast enough.
<<Is there a role for ranitidine in the acute phase?>>
NO, same reason.
<<Where do antihistamines fit in?>>
Acute treatment but that means Piriton IV. Works like magic.
Also preventive treatment but that means long-term treatment. Could he
maybe consult his dentist about this problem if he is so sure the problem
is with his false teeth? And does the lip swelling make anyone think of
angioneurotic oedema? If so then need to check level of something like C1
esterase inhibitor----I think!
In general with recurrent troublesome urticaria:
1. Allergy tests useless.
2. Special diets ditto.
3. Try long-term oral antihistamine, maybe Zirtek or Clarityn or son of
Triludan.
4. If no use add in H2 antagonist eg Cimetidine or Ranitidine
5. If no better THEN try short course of steroid eg Pred 20mg daily for two
weeks
6. If all that no help then ask local derm for relief!
Declan
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