I was referred a healthy 24-year-old with a story of 3 episodes where she would awaken with finger swelling bilaterally. Over the next few days the swelling would decrease, and her skin would flake/peal. Not blistering, nothing that would appear dangerous. total symptoms would last 7-10 days.
She would not have diffuse urticaria, angioedema of other extremities. She was referred here because she had eaten lobster a couple of times and was concerned about lobster allergy. Seafood allergy testing was negative. She did have a positive skin test for dust mites, negative for cat, which she has.
She works as a dental assistant, we tested her for rubber and that was negative.
I recommended that she see a dermatologist, but was wondering if there is some type of inflammatory issue that rings a bell. It does not sound like a mast cell type of process, as it lasted, and the flaking persisted. The 3 episodes have occurred over the past 6 months.
Thank you for your time.