Allergy and itchy Mrs G

Mrs G is a a long-time patient of mine. She is a pleasant old lady of 56 who comes to the hypertension clinic regularly without fail and is compliant of her medication as a result her condition is pretty well under control. As I have quite a number of such patients, I put Mrs G on a three-monthly appointment. And Mrs G would always turn up at the appointed date.

So it was rather a surprise when my nurse told me one morning that Mrs G had insisted to see me ahead of her appointment in a month's time. She came into the clinic looking gaunt and depressed. She claimed she had not been able to sleep restfully for the last few weeks because of the annoying itchiness all over her body. She admitted going to see a private doctor on two occasions the past two weeks and paid nearly RM200.00 for an injection and medications but the itchiness had not subsided and she was really miserable. Luckily her son in law who is a driver to a Federal Minister helped foot the bill, otherwise she would be more unhappy as she is a housewife and her husband is a small time contractor.

I took one look at her body and observed the small reddish patches all over and I noticed the good old GP had even given her high dose steroid but to no avail. I asked her about any new medications,foods or chemicals that she started using just prior to the generalised itchiness. She replied no but I insisted that she try hard to remember. For that kind of skin allergy, it must have been something enveloping her body either internally or externally. Then I asked her whether she had just changed her washing powder and Walla! "That's it", she said. her son- in- law had bought a new clothes detergent about three weeks before and since then she had had the problem. I told her simply to get rid of the detergent and use her old one and to rewash all her clothes. I gave her some anti-histamines after the consultation.

A couple of days ago, Mrs G came in for her hypertension appointment looking healthy and lovely and obviously very pleased with herself. She then announced that her itchiness had gone and she could sleep well now after she discarded the culprit washing detergent.

Again here, there is no miracle medicine but just simple history taking and a high index of suspicion regarding the cause of the allergy. Being my long-time patient also help me to make a faster diagnosis of her condition. For an allergic condition, medications are no answers if the trigger ( the offending agent) is still present.