A 59-year-old female presents with chronic urticaria. She has a history of gastric ulcers and has completed treatment for Helicobacter pylori . Dermatology and allergy evaluations have been done for the patient and the patient has been treated with topical steroids, montelukast, and levocetirizine. However, this management failed to show any improvement in the condition. Attributing the rash to food, the patient followed certain restrictions but trigger avoidance did not alleviate her symptoms. Family history: Not significant with autoimmune diseases Physical examination: Diffuse erythematous, itchy wheals and angioedema on the skin.
The rash was found on both legs, the right side of torso and arms. There was no lymphadenopathy or thyromegaly. Laboratory tests: Calcium levels were found to be elevated, between 10.9 to 11.3 mg/dl. The patient was not on calcium supplementation. Normal…
