Case of skin urticaria.
Patient had skin urticaria since a month, allegra was taken every day for it.
CBC showed a high WBC and a high basophil count. No IGE elevation, no eosinophil elevation. Case history was that patient said it started after taking birthcontrol pills given to regularize her periods, she also said she was gaining weight. All these issues of various types started after covid. The rash was peculiar in that it started after having bath, based on this I asked if she got hot flashes and she said yes, she gets terrible hot flashes. She had acanthosis on the neck and some skin tags showing high insulin resistance. She was also constipated.
I put her on nat sul (for high WBC), lachesis (hot water aggravation, hot flashes at night), akkermensia+leptin resistance, curzinc (for constipation) and Imusil.
After a single dose today morning she had complete clearance of rash and no hot flashes at all, her constipation also cleared.