### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Sir, My age about 60 year is suffering from skin allergy or skin problem since last 8 years in which her skin become patchy and ( starts severe khujali in her arms and face) I have shown to many doctors, some say that it is allergy with gajar ghas and some say it is internal problem it can,t be healed and some say it is life long and it cannot be cured . In Jabalpur I also shown to Skin Specialist ,he gave treatment but after some relief it again reappear and the problem is as it. So ,i request to sir kindly guide us for the treatment of the same.

### output:

Dear Mr MHRA, If your skin comes up in hives or circular red itchy lesions (with central clearing) that disappears on its own or after medications (usually antihistamines) in a few hours, you are most likely suffering from a condition called urticaria. This can also manifest with swelling under the skin or swelling on lips and tongue called angioedema. This is due to histamine release that may be spontaneous or a secondary trigger like scratching (physical), cold or heat (temperature change) or related to hormonal imbalance. Conditions such as diabetes, underactive thyroid, or other autoimmune diseases make it worse when they are uncontrolled and a proportion of patients with urticaria have autoimmune urticaria while in others it may be idiopathic. High-dose long-acting antihistamines for 3 months (minimum duration) may provide extended relief when stopped but may need to be continued for longer. Fexofenadine 180 mg and cetirizine 10 mg twice daily is the usual choice. Thanks.