XCOM: Allergy Unknown
July 7, 2014 8:31 AM   Subscribe

My girlfriend suffers from an intermittent allergic reaction that we cannot track down.

The reaction only affects her hands. Sometimes it will affect only one hand and not the other. Her hands swell or become inflamed. It becomes difficult for her to bend her thumbs. She experiences a very intense, painful itching. Untreated, the reaction can last for more than an hour. Fortunately it responds to benedryl.

We cannot determine what is causing the reaction. She sometimes goes months without experiencing it. Most recently, she experienced it within ten minutes of us leaving our apartment first thing in the morning. The only clue she had was that she had opened laundry that had been wrapped air tight in a plastic bag by our landromat. Our laundromat does not normally put our laundry in plastic. She wondered whether there could have been some volatile chemical in the laundry that normally would have evaporated. Other circumstances include experiencing the reaction after using a public bike, and another while climbing at an indoor rock climbing gym. I think she might have experienced the reaction at the gym two different times.

She's been to a doctor and an allergist but they weren't helpful in fixing things. Any thoughts on what's causing this would be appreciated.
posted by prunes to Health & Fitness (18 answers total) 1 user marked this as a favorite
My first thought are bugbites. Depends on the time of year, where you are all at (temperate, cold, tropical, semi-tropical) and what critter(s) are biting her. Even if it's not bites on her hands, her hands can be affected.

Has she ever had a large attack of bug bites (hundreds of mosquitoes, a dozen bees, fleas)?
posted by Buttons Bellbottom at 8:38 AM on July 7, 2014

I'm not aware of that, but that does remind me of one potentially relevant piece of data: she has had Lyme disease before (many years ago).
posted by prunes at 8:40 AM on July 7, 2014

This could mean her immune system is more susceptible to reacting. Friends with fibro (with and without Lyme in their history) have had similar reactions.

If the critters are out now, it matches to today's reaction. That doesn't negate the dry cleaning chemicals option.

If you were cycling in new areas on the public bike, it matches that reaction.

If the gym was something new it may match for that reaction.

For some, this type of localized swelling, bending issues, and itches that won't go away (but are sometimes helped by Benadryl) its also explained by over exertion or other form of heat exhaustion (cycling without enough water hydration, same with the wall climbing exertion).

I am not any sort of medical professional, much less hers. These are just collected observations from various friends with various similarish issues.

It could be all three - one time chemicals, one time critters, one time overexertion.

You'd need to narrow it down and just keep Benadryl handy. If she can't bend her thumbs she may be unable to temporarily drive (can't keep safe control of the vehicle with her hand grip).
posted by Buttons Bellbottom at 8:57 AM on July 7, 2014 [1 favorite]

I have something similar that happens frequently with my feet. If they get slightly wet and I walk around on an unwashed floor or carpet in our house, they start to itch like they are on fire. I think it might have something to do with our cats. I cope with the pain by sticking them in the sink with ice cubes (I've never tried Benadryl, always seemed slower than ice).

My way of looking at it is that whatever it is is something environmental that I can't control, and same goes for your girlfriend (sounds like it's random enough that she can't predict it). So, she just has to be ready to deal with it on the go. Carry Benadryl everywhere. If weather permits, try to wear gloves more often. If popping an occasional antihistamine helps, she should consider herself lucky. There's all sorts of toxic shit in our environment, and it's not going away anytime soon, sadly.
posted by tk at 9:01 AM on July 7, 2014 [1 favorite]

Has she tried an elimination diet? A friend had a similar problem (an itchy rash on both middle fingers, doctors were no help) and when he stopped eating dairy an unexpected result was the rash went away. I don't know how long it took -- he'd quit eating dairy because he'd become lactose intolerant, and then one day realized the finger rash had gone away and not returned.
posted by The corpse in the library at 9:08 AM on July 7, 2014

Laundry plastic bag, bike handles and rock climbing hand-holds all have some form of rubber or plastic on them, so that is a possible connection. Was she wearing gloves at the rock climbing place (her own or borrowed ones)? Has she gone to the gym without having a reaction, or is it every time she visits?
posted by soelo at 9:51 AM on July 7, 2014

Regarding the bike incident, she actually uses the public bikes (NYC's Citi Bike program) pretty frequently, and she's only had the reaction that one time. So I'm more inclined to think that it's something that either could have gotten on to the bike, or that the bike is just a red herring.

She wasn't wearing gloves at the rock wall. She was using climbing chalk though. These chalks have different compositions. I know that sometimes people are allergic to certain ingredients in them. I don't think the problem is with her chalk. At the gym one gets exposed to the chalks of many other people as well.
posted by prunes at 10:29 AM on July 7, 2014

Kind of sounds like the itching and redness may be secondary to Edema. Edema is when excess fluid gets trapped in body tissues and results in swelling. This swelling may cause mast cells to release histamine which is why antihistamines help. Exercise can cause edema in some cases. It is known as exercise induced edema. Does the redness have any particular rash or is it more of just a hot redness?
posted by The Violet Cypher at 10:32 AM on July 7, 2014 [3 favorites]

I'm allergic to certain perfumes, and have to be very careful with the laundry detergents I choose. Also, perfumed hand creams/moisturizers are often problematic, especially as they tend to stick to things touched by their users.
posted by flabdablet at 10:46 AM on July 7, 2014 [2 favorites]

Find another allergist and get a second opinion. Bring in all the data you can think of regarding what she may have touched or ingested up to eight hours before each incident.
posted by feckless fecal fear mongering at 11:19 AM on July 7, 2014

I get swelly itchy hands sometimes - I'm pretty sure it's hives. I have allergies to all sorts of things, so I don't even bother trying to figure out exactly what is setting me off, I just try to deal with the symptoms. I imagine that it's some sort of pollen that is pretty much unavoidable, and seasonal. However, if you look at the wikipedia link, hives can be set off by all sorts of different things, not all of which are allergens. It usually happens when I'm walking to work on a hot day, and especially if I'm feeling stressed. Things that help - washing my hands with cold water, gently rubbing ice on the itchy area, cleaning the area with rubbing alcohol, and taking a few minutes to try to relax and unwind a bit. Something I have been meaning to try is getting some sort of wet hand wipes that I can carry in my purse to rub my hands with at the first sign of itchiness - the sooner I do something to ease the itching, the less affected I will be. It also really helps to resist scratching, that makes it way worse.
posted by 5_13_23_42_69_666 at 11:24 AM on July 7, 2014

also, if I get it while out walking, it often will affect whatever hand is hanging by my side instead of the one that is propped up on my bag, so I make a point of switching which side my bag is carried on so both hands get some time being supported. Just mentioning it because you said she sometimes only gets it on one hand.
posted by 5_13_23_42_69_666 at 11:28 AM on July 7, 2014 [1 favorite]

Is the swelling mostly in the soft tissue of her hands or in the joints? I don't think this is how RA initially presents but I guess it could be a possibility? Maybe? i am so obviously not a doctor.

Aside from these wild speculations, I have personally had a thing like this that was due to a spider bite. Every time I was bit by any other kind of biting insect on that hand, or had any other kind of allergic irritant bothering me (cats, hay fever, etc) the location of the old bite would swell up enormously; as it was between two fingers on the back of the hand, the two closest fingers would swell and itch abominably. It went away after a couple of years and I never bothered seeing a doctor about it.
posted by elizardbits at 11:36 AM on July 7, 2014

My daughter used to get a lot of Mystery Hives, especially on her hands, because she has a serious peanut allergy. It turns out there's peanut slime on a lot of stuff out there in the world. Think: the bucket of crayons at the diner that another kid eating a PBJ used, the handle of the grocery cart, basically any surface at the Children's Museum.

I don't mean to suggest that your girlfriend has a peanut allergy. But there may be some other substance that she needs only to be exposed to a very small amount of to react. A lot of the things you mention -- bike handles, a climbing wall, the dry cleaner's plastic -- pass through at least a few different hands before she touches them. The problem may not be anything visible or obvious; it may be trace amounts of whatever mystery substance (possibly a food) was on somebody else's hands when they touched an object right before she did.
posted by Andrhia at 12:11 PM on July 7, 2014

I think that's right, but in that case how does one treat the problem? Do you just need to learn to live with it?
posted by prunes at 12:14 PM on July 7, 2014

The only thing I can think of that each of those surfaces might have in common is that they were wiped/sprayed down with a disinfectant.

Has she interacted with hand sanitizers or other cleaning sprays without problem?
posted by sciencegeek at 1:36 PM on July 7, 2014

For my kid, yeah, basically we had to learn to live with it, try to teach her not to touch stuff unnecessarily, always carry Benadryl, and engage in very frequent hand-washing with soap and water. Hand sanitizer doesn't help an allergic reaction, since it kills germs but it doesn't denature proteins.

Triaminic makes quick-dissolve thin strips for children marketed as allergy medicine that are only diphenhydramine HCl -- the same chemical as in Benadryl. They come in flat foil packets that are very easily tucked into a wallet or credit card slot. (It's the grape flavor only, the purple box. Look at the ingredients to make sure you have the right one.) You may have to amp up dosage for an adult, but it's tremendously easy and portable, so you always have quick relief with you when you're out. (Benadryl has a thin-strips product, too, but I can't vouch for the convenience of their packaging.)

Since it's occurred twice at the climbing wall, it's possible that it's a food or product routinely used by someone who climbs with or right before her. Some persistent sleuthing about routes might eventually help to figure out the who and what.

But really I'm surprised your allergist couldn't or wouldn't help you further, given a contact allergy like this could potentially be a life-threatening allergy on ingestion (if it is food). Have they done ELISA or skin tests?

Good luck. Mystery allergies are the pits. :/
posted by Andrhia at 1:59 PM on July 7, 2014 [1 favorite]

Like sciencegeek, my first thought was cleaning chemicals, and specifically bleach (because I know someone with a very strong chlorine allergy).
posted by freezer cake at 3:44 PM on July 8, 2014

« Older I don't even know how to ask this question   |   Research paralysis -- moving past: "what's the... Newer »
This thread is closed to new comments.