Re: Hives on rosacea, Nasalcrom - HELP!!

[Guest guest]

Hi Patty,

I remember that Dr. Nase posted about topical sodium cromolyn and

some successes Drs. and Sorensen from LSU Medical Center had

with it for inflammatory skin conditions.

http://groups.yahoo.com/group/rosacea-support/message/2517

If Marjorie wouldn't mind, maybe she could email these physicians to

find out if this topical is still being worked on or came to a dead

end.

Take care,

Matija

> Hi group: My ETS results are still great. My blushing and

thermal

> related triggers are gone. It has been a huge help. My facial

skin

> is much, much less red and inflammed.

>

> Now I can concentrate on the other problem I have always had with

my

> rosacea. I have always gotten hives on my arms, legs, torso and

> face. My rosacea skin area is especially sensitive to them and

they

> show up more often in that area. I think this is due to the

> instability of our mast cells in that area. Whenever I get the

hives

> on my face it is awful. They itch terribly and look ridiculous. I

> have taken hydroxyzine for the hives and it has helped. During

> allergy season I get worse, especially when I eat raw food;

> especially ANY fruits. Sounds bizarre, but it's been going on for

6

> years. Anyway, I recently tried putting nasalcrom (a non-steriodal

> mast cell stabilizer normally for the nose-a nose spray) on my

right

> cheek. I did this for about 3 weeks. Yesterday I ate too much

fruit

> and had a breakout of hives. Normally the hives are very

symmetrical,

> but this time they were mostly on the left side, which makes me

think

> the nasalcrom is working on the right side. So my question is,

does

> anyone know if its possible for nasalcrom to actually work in this

> way?

>

> Thanks! Patty

[Guest guest]

>>

>>> Now I can concentrate on the other problem I have always had with

>> my

>>> rosacea. I have always gotten hives on my arms, legs, torso and

>>> face. My rosacea skin area is especially sensitive to them and

>> they

>>> show up more often in that area. I think this is due to the

>>> instability of our mast cells in that area. Whenever I get the

>> hives

>>> on my face it is awful. They itch terribly and look ridiculous.

> I

>>> have taken hydroxyzine for the hives and it has helped. During

>>> allergy season I get worse, especially when I eat raw food;

>>> especially ANY fruits. Sounds bizarre, but it's been going on

> for

>> 6

>>> years.

It sounds like food allergies or at the least an allergic reaction. I'm not

trying to be flip, but if you know that raw food/fruit causes hives why do

you eat them? Perhaps I've missed something here...Adjusting your diet

sounds a whole lot better to me than taking medications to handle recurrent

symptoms. You might find relief by following an avoidance diet for a while

and then slowly adding certain foods back in to isolate reactions.

carrie

[Guest guest]

Matija, I read Dr. Nase's 1999 post. Attributing the inflammatory and

vasodilatory effects of rosacea to mast cell activation is an

intriguing idea, though I would expect rosacea to have a somewhat

different presentation and respond more uniformly to certain

medications. But perhaps mast cell activation is a prominent feature

in a subset of rosaceans, or a low key player in mainstream rosacea?

Certainly it may play a role in those with a component of contact

dermatitis, as local mast cell activation does in other allergy-

mediated disorders. Intriguing, but I need convincing that it's a

significant culprit in mainstream rosacea.

I checked the main pharmaceutical database, Drugdex, and it said that

topical cromolyn was not found effective in adults with atropic

dermatitis (which would seem the best indication for topical

cromolyn). It sounds like topical application was found ineffective

or inconsistent in stabilizing skin mast cells; there are no topical

cromolyn preparations available in the US. Evidence in children was

more hopeful, but primarily as an adjunct to hydrocortisone cream

(still the gold standard, despite all its problems), and again there

are no preparations sold in the US. According to the Web, Dr.

and Sorensen are or were pediatricians/allergists at LSU Medical

Center, which explains why they were testing topical cromolyn. I may

be missing something, but I don't see how contacting them today will

be of practical benefit to us rosaceans.

Patty, your symptoms don't sound bizarre to me; but as you describe

them, they sound like an allergic reaction, not rosacea; even though

the rash appears disproportionally on your face, that's not uncommon

in allergic reactions. If so, you might consider talking to your

doctor about better antihistamine (H1 and H2 blocker) therapy,

especially since you found Atarax helpful after-the-fact. If that

doesn't help, then you and your doctor might consider a trial of oral

cromolyn; that's used for managing the GI symptoms of food allergies

in adults, but has some systemic effects in stablizing skin mast

cells in children. I've never prescribed it, but it's taken as a

liquid four times a day, so it's a bit of a hassle compared to

antihistamine therapy. Significantly, I've not seen any side-by-side

tests to know whether it would be more effective for allergic skin

reactions than H1 and H2 blocker therapy, which are safe and

effective.

I enjoy learning about and discussing new research, although I'm very

aware of my limitations in this regard. I guess it's obvious I don't

share the enthusiasm for all these new therapies that seem to

characterize this group. In my experience, scientific research is

wonderfully logical and creative, and designing and executing

research naturally calls forth its own enthusiasm; everyone is always

hopeful the next study will be " it. " But the more experience one has

in science, law, philosophy, investigative journalism, and other

fields, the more one knows that " making a case " doesn't make it so.

Assertions and common sense logic are literally a dime a dozen -- the

real money is in the proof (by which I mean good proof).

Marjorie

Marjorie Lazoff, MD

> Hi Patty,

>

> I remember that Dr. Nase posted about topical sodium cromolyn and

> some successes Drs. and Sorensen from LSU Medical Center had

> with it for inflammatory skin conditions.

>

> http://groups.yahoo.com/group/rosacea-support/message/2517

>

> If Marjorie wouldn't mind, maybe she could email these physicians

to

> find out if this topical is still being worked on or came to a dead

> end.

>

> Take care,

> Matija

>

>

>

>

> > Hi group: My ETS results are still great. My blushing and

> thermal

> > related triggers are gone. It has been a huge help. My facial

> skin

> > is much, much less red and inflammed.

> >

> > Now I can concentrate on the other problem I have always had with

> my

> > rosacea. I have always gotten hives on my arms, legs, torso and

> > face. My rosacea skin area is especially sensitive to them and

> they

> > show up more often in that area. I think this is due to the

> > instability of our mast cells in that area. Whenever I get the

> hives

> > on my face it is awful. They itch terribly and look ridiculous.

I

> > have taken hydroxyzine for the hives and it has helped. During

> > allergy season I get worse, especially when I eat raw food;

> > especially ANY fruits. Sounds bizarre, but it's been going on

for

> 6

> > years. Anyway, I recently tried putting nasalcrom (a non-

steriodal

> > mast cell stabilizer normally for the nose-a nose spray) on my

> right

> > cheek. I did this for about 3 weeks. Yesterday I ate too much

> fruit

> > and had a breakout of hives. Normally the hives are very

> symmetrical,

> > but this time they were mostly on the left side, which makes me

> think

> > the nasalcrom is working on the right side. So my question is,

> does

> > anyone know if its possible for nasalcrom to actually work in

this

> > way?

> >

> > Thanks! Patty

[Guest guest]

Matija, I read Dr. Nase's 1999 post. Attributing the inflammatory and

vasodilatory effects of rosacea to mast cell activation is an

intriguing idea, though I would expect rosacea to have a somewhat

different presentation and respond more uniformly to certain

medications. But perhaps mast cell activation is a prominent feature

in a subset of rosaceans, or a low key player in mainstream rosacea?

Certainly it may play a role in those with a component of contact

dermatitis, as local mast cell activation does in other allergy-

mediated disorders. Intriguing, but I need convincing that it's a

significant culprit in mainstream rosacea.

I checked the main pharmaceutical database, Drugdex, and it said that

topical cromolyn was not found effective in adults with atropic

dermatitis (which would seem the best indication for topical

cromolyn). It sounds like topical application was found ineffective

or inconsistent in stabilizing skin mast cells; there are no topical

cromolyn preparations available in the US. Evidence in children was

more hopeful, but primarily as an adjunct to hydrocortisone cream

(still the gold standard, despite all its problems), and again there

are no preparations sold in the US. According to the Web, Dr.

and Sorensen are or were pediatricians/allergists at LSU Medical

Center, which explains why they were testing topical cromolyn. I may

be missing something, but I don't see how contacting them today will

be of practical benefit to us rosaceans.

Patty, your symptoms don't sound bizarre to me; but as you describe

them, they sound like an allergic reaction, not rosacea; even though

the rash appears disproportionally on your face, that's not uncommon

in allergic reactions. If so, you might consider talking to your

doctor about better antihistamine (H1 and H2 blocker) therapy,

especially since you found Atarax helpful after-the-fact. If that

doesn't help, then you and your doctor might consider a trial of oral

cromolyn; that's used for managing the GI symptoms of food allergies

in adults, but has some systemic effects in stablizing skin mast

cells in children. I've never prescribed it, but it's taken as a

liquid four times a day, so it's a bit of a hassle compared to

antihistamine therapy. Significantly, I've not seen any side-by-side

tests to know whether it would be more effective for allergic skin

reactions than H1 and H2 blocker therapy, which are safe and

effective.

I enjoy learning about and discussing new research, although I'm very

aware of my limitations in this regard. I guess it's obvious I don't

share the enthusiasm for all these new therapies that seem to

characterize this group. In my experience, scientific research is

wonderfully logical and creative, and designing and executing

research naturally calls forth its own enthusiasm; everyone is always

hopeful the next study will be " it. " But the more experience one has

in science, law, philosophy, investigative journalism, and other

fields, the more one knows that " making a case " doesn't make it so.

Assertions and common sense logic are literally a dime a dozen -- the

real money is in the proof (by which I mean good proof).

Marjorie

Marjorie Lazoff, MD

> Hi Patty,

>

> I remember that Dr. Nase posted about topical sodium cromolyn and

> some successes Drs. and Sorensen from LSU Medical Center had

> with it for inflammatory skin conditions.

>

> http://groups.yahoo.com/group/rosacea-support/message/2517

>

> If Marjorie wouldn't mind, maybe she could email these physicians

to

> find out if this topical is still being worked on or came to a dead

> end.

>

> Take care,

> Matija

>

>

>

>

> > Hi group: My ETS results are still great. My blushing and

> thermal

> > related triggers are gone. It has been a huge help. My facial

> skin

> > is much, much less red and inflammed.

> >

> > Now I can concentrate on the other problem I have always had with

> my

> > rosacea. I have always gotten hives on my arms, legs, torso and

> > face. My rosacea skin area is especially sensitive to them and

> they

> > show up more often in that area. I think this is due to the

> > instability of our mast cells in that area. Whenever I get the

> hives

> > on my face it is awful. They itch terribly and look ridiculous.

I

> > have taken hydroxyzine for the hives and it has helped. During

> > allergy season I get worse, especially when I eat raw food;

> > especially ANY fruits. Sounds bizarre, but it's been going on

for

> 6

> > years. Anyway, I recently tried putting nasalcrom (a non-

steriodal

> > mast cell stabilizer normally for the nose-a nose spray) on my

> right

> > cheek. I did this for about 3 weeks. Yesterday I ate too much

> fruit

> > and had a breakout of hives. Normally the hives are very

> symmetrical,

> > but this time they were mostly on the left side, which makes me

> think

> > the nasalcrom is working on the right side. So my question is,

> does

> > anyone know if its possible for nasalcrom to actually work in

this

> > way?

> >

> > Thanks! Patty

[Guest guest]

Hi Marjorie,

Thanks for your thorough answer. I didn't know about Drugex, the

pharmaceutical database, and what this database contains. You don't

have to contact Drs. and Sorensen. I was interested in the

progress, or lack thereof, for the topical sodium cromolyn and

inflammatory skin condition that Dr. Nase mentioned in that message.

It's good to know more details about this as we hear things or read

articles that say the next big thing is coming for skin conditions.

Then, you hear nothing about it. You've mentioned why this happens

in past messages, and it's because the new thing didn't work

correctly or it's just a marketing ploy. I appreciate your honesty!

As an aside, Marjorie, do any foods cause you to flare? I was just

curious about that. Also, do you have any guesses as to why certain

foods can trigger rosacea flares in some people?

Thanks!

Matija

> > > Hi group: My ETS results are still great. My blushing and

> > thermal

> > > related triggers are gone. It has been a huge help. My facial

> > skin

> > > is much, much less red and inflammed.

> > >

> > > Now I can concentrate on the other problem I have always had

with

> > my

> > > rosacea. I have always gotten hives on my arms, legs, torso

and

> > > face. My rosacea skin area is especially sensitive to them and

> > they

> > > show up more often in that area. I think this is due to the

> > > instability of our mast cells in that area. Whenever I get the

> > hives

> > > on my face it is awful. They itch terribly and look

ridiculous.

> I

> > > have taken hydroxyzine for the hives and it has helped. During

> > > allergy season I get worse, especially when I eat raw food;

> > > especially ANY fruits. Sounds bizarre, but it's been going on

> for

> > 6

> > > years. Anyway, I recently tried putting nasalcrom (a non-

> steriodal

> > > mast cell stabilizer normally for the nose-a nose spray) on my

> > right

> > > cheek. I did this for about 3 weeks. Yesterday I ate too much

> > fruit

> > > and had a breakout of hives. Normally the hives are very

> > symmetrical,

> > > but this time they were mostly on the left side, which makes me

> > think

> > > the nasalcrom is working on the right side. So my question is,

> > does

> > > anyone know if its possible for nasalcrom to actually work in

> this

> > > way?

> > >

> > > Thanks! Patty

[Guest guest]

> I didn't know about Drugdex, the

> pharmaceutical database, and what this database contains.

Matija, Drugdex is a huge well-respected electronic database

(microfiche before that, it's been around for decades) that's

available to hospital pharmacies for pharmacists. It covers research,

clinical minutia, pharmacokinetics, interactions, everything on a

particular medication. It was created and is maintained quarterly by

a private company, Micromedex.

> As an aside, Marjorie, do any foods cause you to flare? I was just

> curious about that. Also, do you have any guesses as to why certain

> foods can trigger rosacea flares in some people?

Nope, my only triggers are my computer monitor (in low humidity -- an

important discovery I made here) and my period.

It's well known that certain foods/alcohol/drugs cause flushing in

rosaceans and non-rosaceans (though certainly disproportionally in

rosaceans), and food allergies and perhaps intolerances cause

allergic skin reactions (people with rosacea are at least as likely

as the general population to suffer from food intolerances and

allergies). Their mechanisms are fairly well understood, I believe.

To me those aren't necessarily rosacea flares, but I see that it

depends how each person self-assesses their own condition. I don't

know if there's a separate food-related reaction unique and

characteristic of rosacea only. I don't know the mechanism behind

*any* rosacea flare.

Sorry, no clear answers -- I'm learning along with everyone else.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> I didn't know about Drugdex, the

> pharmaceutical database, and what this database contains.

Matija, Drugdex is a huge well-respected electronic database

(microfiche before that, it's been around for decades) that's

available to hospital pharmacies for pharmacists. It covers research,

clinical minutia, pharmacokinetics, interactions, everything on a

particular medication. It was created and is maintained quarterly by

a private company, Micromedex.

> As an aside, Marjorie, do any foods cause you to flare? I was just

> curious about that. Also, do you have any guesses as to why certain

> foods can trigger rosacea flares in some people?

Nope, my only triggers are my computer monitor (in low humidity -- an

important discovery I made here) and my period.

It's well known that certain foods/alcohol/drugs cause flushing in

rosaceans and non-rosaceans (though certainly disproportionally in

rosaceans), and food allergies and perhaps intolerances cause

allergic skin reactions (people with rosacea are at least as likely

as the general population to suffer from food intolerances and

allergies). Their mechanisms are fairly well understood, I believe.

To me those aren't necessarily rosacea flares, but I see that it

depends how each person self-assesses their own condition. I don't

know if there's a separate food-related reaction unique and

characteristic of rosacea only. I don't know the mechanism behind

*any* rosacea flare.

Sorry, no clear answers -- I'm learning along with everyone else.

Marjorie

Marjorie Lazoff, MD