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30 years
For a year now, everytime I eat spices or chocolate my body starts itching and I have red spots all over. When I put cold water or go to a cold room, it decreases and disappears, what's happening?
Sep 15, 2014

Dr. Zakia Dimassi Pediatrics
A hypersensitivity reaction is an exaggerated body response to a particular substance, called allergen; such reactions do not happen under normal circumstances. There are 4 types of hypersensitivity reaction: types I, II, III and IV. They differ in the type and severity of symptoms, and underlying pathological processes.
Type I hypersensitivity reaction is the type you are getting upon ingesting chocolate or spicy food; it is an immediate immune reaction, ie it happens immediately after exposure to the particular substance. Type I reactions underlie atopic disorders (eg, allergic asthma, rhinitis, conjunctivitis), anaphylaxis, some cases of angioedema, urticaria, and latex and some food allergies. Type I reactions develop < 1 h after exposure to antigen, which is why they are known as immediate hypersensitivity reactions
Type I hypersensitivity reactions are very common, namely, allergic rhinitis (hay fever), allergic conjunctivitis, and asthma are frequently encountered, and the number of cases of type I hypersensitivity diseases is continuously increasing worldwide.
As a general rule, having a type I hypersensitivity disease increases the risk of having another.
Type I hypersensitivity reactions are IgE-mediated reaction; IgE, or ImmunoGlobulin E, are a type of antibodies that underlie allergic reactions. Upon exposure to allergens, these antibodies bind to the allergens, eventually leading to the release of histamines, a substance secreted by a specific type of cells (known as the mast cells) and that is responsible for allergic symptoms). Ultimately, the affected individual will have symptoms such as swelling, increased secretion discharge, redness, etc.
There is no particular cure for this type of allergic reaction, treatment aims to control the severity of the symptoms or to prevent them all together.
Of note, the body may, and for no particular reason, suddenly develop allergy to a substance that previously did not trigger any reaction. This is known as idiosyncratic allergic reaction – it may persist, or may resolve suddenly as well and without intervention.
Depending on the severity of the allergic reaction, different treatment approaches are followed. Severe allergic reaction such as anaphylaxis and angioedema (a life-threatening allergic reaction with diffuse body swelling, including airway swelling, with the risk of inability to breathe) requires immediate medical attention as death may ensue within minutes
Diseases that are not life-threatening may be treated less aggressively. Treatment options include the following:
• allergen avoidance: prevention and avoidance of possible triggers are the mainstay of the treatment. In your case, you obviously need to avoid eating chocolate and spicy food (I’m sorry I know this is unpleasant).
• antihistamines: either topically applied on the affected areas, or taken by mouth. Antihistamines include fexofenadine, loratadine and cetirizine.
• steroids: these include prednisolone, dexamethasone, etc. They can be applied topically (on your skin) or taken by mouth. In your case, I do not think steroids are needed at this stage, as the reaction seems mild. If however the reaction gets worse, steroid use may be required.
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