Dr. Gott: Hives may be caused by infection

Dear Dr. Gott: My husband has a perplexing problem with hives. He is 59 years old.

He is currently taking Benicar, Toprol, simvastatin and a low-dose aspirin every day for cholesterol and blood pressure problems but is in good overall health.

I don’t believe these play a role in his current affliction, however, because the hives started several years before he was prescribed these medications.

He first began getting the hives while working, but now that he is retired, they still occur. He has seen his primary-care physician and an allergist, both of whom have not been able to offer any suggestions. After hearing a detailed description of an “attack,” they both said they didn’t believe it was due to food or drug allergies.

He has seen his physician a few times during an attack, but all they do is give him some sort of injection and a prescription for prednisone, which he doesn’t like to take.

Dear Reader: Your husband appears to be having several attacks of acute urticaria (hives) a year. Acute in this instance means that the hives last for fewer than six weeks.

According to both the American Academy of Dermatology and the American College of Allergy, Asthma and Immunology, there are three common causes of urticaria: Allergies to foods (such as shellfish, peanuts, dairy or others); reactions to medications, such as penicillin; and infections. Insect bites, internal diseases, cold and sunlight are other, less common causes.

I believe the cause of your husband’s hives is infection. Thanks to your detailed description, it appears that there are two things going on. First, he experienced swelling and redness in a small area that progressed throughout the day.

He then developed upper-respiratory-infection symptoms (which can take 12 to 36 hours to appear following exposure), followed by worsening hives.

I don’t think there is any coincidence in the fact that his symptoms last about seven days, which is the average length of the common cold. Since I am not an allergist, I cannot give specific information about how to treat these hives.

If your husband improves while using prednisone, I urge him to speak with his physician about using it. Small doses for short periods of time will not cause side effects and long-term damage is unlikely. The prednisone probably won’t help the cold but it will be a lot easier to deal with a simple cold by itself without having itchy, swollen blotches all over his body as well.

Bring my response to his allergist and ask his opinion. He or she should also be able to provide possible treatment options at that time.

• Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.