• Irritants: Physical, chemical or electrical.

• Sensitizers: Plants, cosmetics, clothing, ointments and occupational hazards, alkalis like soap.

• Climate: Temperature and humidity e.g. photodermatitis.

• Drugs: Given for the disease or otherwise. Systemically administered drugs can produce a number of morphologically distinct cutaneous eruptions. Macular, maculopapular lesions and urticaria are the most undesirable effects caused by drugs along with itching, fever, eosinophilia etc.
• Mental and emotional conflict strains and stresses

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Urticaria or Hives are itchy, burning swellings that appear on the skin as an indication of an allergic sensitivity to various allergies especially with a family history.

The most common allergies are:

a)    Food: Food allergy due to some item that has been consumed within a day or        two will give rise to generalized itching, abdominal cramps and loose stools.        The common (food) allergens are eggs, nuts, wheat, chocolate, cocoa, prawn,        crabs, nuts and food dyes and additives etc.
b)    Sprays and inhalants.
c)    Dust and Pollutants.
d)   Drugs: Many Drugs, vaccines and hormone preparations can precipitate             urticaria.
e)    Physical factors: e.g. cold, heat, pressure, and exertion.
f)    Worms.
g)   Insect bites.
h)   Pollen.
i)    Cosmetics.

The development of urticaria occurs when the body releases histamines into the blood stream or tissues as a allergic response causing widening of the capillaries thereby allowing the plasma to escape through its walls resulting in swellings on the skin surface.

Symptoms
Urticaria appears as red or white blotches on the skin accompanied by itching and burning. They may disappear as suddenly as they came or they may last for several days.

a) Severe itching proceeds the attack.
b) Eruptions of various sizes usually appear.
c) In a few minutes, eruptions may develop, spread, and coalesce to form larger     hives.
d) Any part of the body may be affected.

Complications
The most serious complication is the development of giant hives known as Angio-neurotic edema. This condition appears on eyelids, lips or tongue accompanied by swelling. When the swelling is internal especially in the air-passages it can lead to obstruction in breathing.

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secretion including increased production of sebum from the sebaceous glands in the skin. In girls this may be more pronounced at the premenstrual period. Certain foods especially to which the patient is allergic also cause an increase in the activity of the sebaceous glands. The most common offenders are chocolates, nuts, cheese and fatty foods.

If a hair follicle opening on the surface of the skin is small or is clogged by dirt or heavy cosmetics the fatty material made by the sebaceous glands accumulates and a `LUMP' appears under the skin, and a white head or black head `Comedone' shows on the surface.
 

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Seborrhic Dermatitis/Dandruff
It has been observed that dandruff is more common in people with a family history of allergic manifestation. In this condition there is diffuse scaliness of the scalp. It is of the dry and greasy variety.

The condition can be spread to other hairy regions of the body e.g. eyebrows, beard, axilla, genitalia etc.

The basic defect is the over production and/or change in composition of sebaceous secretion. It is further aggravated by endocrine disorders, unbalanced diet, constipation etc.

 

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Leucoderma
It is an acquired depigmentary condition characterized by completely depigmented patches of varying sizes and shapes. Besides loss of colour there is no other structural change. Any part of the body can be affected, but the most common sites are hands, face, trunk and legs.

In our experience vitiligo usually has a familial predisposition.

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Psoriasis

It is a common, chronic non-infectious skin disease whose course is punctuated by intermissions and remissions. Attacks are more common in winters. It has been commonly observed that it is a hereditary familial disease aggravated by stress, mental trauma, physical injury, digestive upsets etc. It is characterized by well defined slightly raised, dry erythematous macules with silvery scales and a typically extensor distribution e.g. scalp, palms, soles, nails etc.

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Alopecia

Usually occurs in association with dandruff. There is usually a genetic predisposition. Partial or complete loss of hair, most commonly on the scalp occurring as a consequence of usually genetic or hormonal factors. It may be associated with dandruff. The hair loss may occur without scarring or gross atrophic changes (noncicatricial) or may follow inflammation, tissue destruction or scar tissue formation (cicatricial).

a) Noncicatricial Alopecia: Premature baldness is of frequent occurrence in males     often with a history of familial baldness. The initial hair loss occurs in the lateral     frontal areas or over the vertex. Thinning of hair is not infrequent in females, but     complete baldness in any area is rare. b) Alopecia areata: Sudden loss of hair in circumscribed areas occurs. Any hairy     area may be involved, the scalp and beard area are most common. c) Alopecia Universalis: Rarely all the body hair may be lost. d) Traction Alopecia: A characteristic pattern of hair loss may be seen in people     who tie their hair in knots and apply excessive traction in the process.   e) Cicatricial Alopecia: If hair loss is due to atrophy or scarring, no regrowth is     possible. In injuries e.g. burns, physical trauma, X-ray the genesis of the     scarring is readily apparent. Deep ulcers, SLE, tinea capitis etc. also cause     alopecia.