instruction: hello doctor I would like to consult for my disturbing allergic flares I am a year old female I am not known hypertensive diabetic or asthmatic within these three months I have history of morning colds nasal congestion pruritic rashes and eye itchiness I have no fever no cough shortness of breath headache and sore throat I took monetlukast cetirizine once a day and applied olopatadine optic drops four times a day which did not relieve my symptoms therefore I added loratadine 10 my tablet at bedtime I tried a hypoallergenic diet as well after two weeks still without relief I added prednisone my tablet with a tapering dose for two weeks there was no significant relief of symptoms now I am still on montelukast cetirizine once tablet once a day and loratadine 10 my one tablet once a day at bedtime my rashes are getting worse and my sneezing as well please help
output: hello regarding the treatment I suggest you continue the medicines as they are I would like to know how much of prednisolone did you start with nextly you must start on intranasal steroids to help relieve the nasal symptoms use fluticasone furoate twice daily two puffs in each nostril twice daily the brands available in the philippines are avamys flutiair nasoflo flusort if you feel the antihistaminics are making you drowsy then you may keep the cetirizine for the evening and take loratidine in the morning apply a mild steroid cream like betamethasone valerate 1 topical cream over the affected skin the brands available in your country are diprolene diprosone and betnovate long term solution you must do a skin prick testing to check what you are allergic to skin prick testing is better than blood allergy testing both the methods check for food and aeroallergens remember that before the testing you should stop the antihistaminics for five days with such a test we will come to know the offending agent and give you the right advice to prevent that particular allergen do revert back for more details apply mild soap and wear loose fitting clothes to avoid friction over the affected area on the skin