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

### input:
I have been taking Lisinopril/HCTZ for about six years. I was initially prescribed 40 mg/day, but about three years ago the dosage was changed to 20 mg/day. It seemed to be working well, until Tuesday, January 21st, about 2:00 PM, I noticed tiggling in both my hands after taking a shower. The tingling turned into viscous red itching hives on my hands that traveled up my forarms to my elbows. The next morning I went to the ER, where they told me that it was probably a reaction to penicillian that I was given for a throat infection. I have taken penicillin before in the past, (I m a 48 year old African American female), and was suprised to hear that after having taken the medication for about nine days, I would develop an allergic reaction. I threw the last two remaining doses of penicillin away, took the prednisone medication and benydril capsules given to me and went to bed. The next morning, I noticed that my hands had swollen up painfully. The hives I had previously on my forarms had gone away, but new more numerous smaller hives were there. I also had numerous hives on my lower torso, and thighs, some small about a quarter of an inch in diameter, some huge, almost five inches in diameter! My lower legs, feet, upper torso and face were completely unaffected. I took more benedyl and my second dose of prednisone and went to bed. Today I woke up with a swollen lip, dizziness, difficulty breathing, and even more vicious, numerous hives on my forearms, lower torso, and thighs. The benedryl capsules were useless and the predisone was not working. I went back to the ER where the doctor gave me benedryl intraveneously, and a stronger 6 day regime of predisone, and blamed this time the Lisinopril that I have been taking. My question is this. Why on earth would I have such severe hives and swelling now after being symptom free with Lisinopril for six years. Also, I wanted to add that I had been using a new body soap for about two weeks without any adverse reactions, and I had bought a new laundry detergent that I used for about a month without any previous adverse reactions. I have been going over my movements for the past week and can come up with absolutely no changes in eating, bathing, hygiene practices, etc. that would begin to address such a strong acute reaction. Your comments please... Sincerely, Ann Coney Denver Colorado

### output:

Hi. Thanks for posting your concern at ChatDoctorI would keep a possibility of Acquired Angioedema due to ACE Inhibitor (Lisinopril) and Urticaria. Angioedema due to ACE Inhibitors is usually not associated with urticariaAngioedema or Quinces edema is the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues. ACE inhibitors are one of the common cause of Angioedema. You have been on lisinopril which is an ACE inhibitor!! Though ACE Inhibitor induced Angioedema is noticed at the beginning of therapy, but sometimes it can happen later on. Urticaria OR hives can occur due to various causes like(to name a few):-Infections(bacterial, viral, fungal)- Chat Doctor. -Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc-Autoimmune disorders like SHE, RA etc.-A few cases have no underlying cause and are known as idiopathic urticaria. I would advise you to get few basic lab tests like Hologram, stool for ova/cyst, Urine routine, Chest X-ray. An oral antihistamine like Fexofenadine OR Loratadine once or twice daily for a week would be suitable. They are non-sedating and won't affect your alertness level. A topical soothing lotion like calamine would help you symptomatically. Take care regards