Can you make the diagnosis?

Frank is at a cocktail party, and is enjoying a martini and the hors d’oeuvres.  As he is talking with clients, he begins to notice a swelling feeling of his lips, and then of his tongue.

He tries to continue with the conversation, but starts feeling like the room is very hot, and also his skin starts feeling itchy.  He decides to go to the restroom.  Once there, he sees in the mirror that his upper lip looks swollen.  He lifts his shirt, and sees a rash:


What does Frank have?

  1.  An allergic reaction
  2.  The measles
  3.  A reaction to alcohol
  4.  A heat rash



If you guessed 1.  An allergic reaction, you are correct!

Frank is likely having a reaction to something in the hors d’oeuvres.  More than 3 million people have an allergic reaction per year. Symptoms can include itchy, raised red welts called “hives” on the skin’s surface, lip or tongue swelling, and shortness of breath.  The most common food allergy is from seafood.

Treatment for an allergic reaction includes medications such as anti-histamines (Benadryl) and steroids.  In some cases breathing treatments such as albuterol and epinephrine may be necessary.  If a patient is having lip or tongue swelling, or any difficulty breathing, they must be seen in the Emergency Department.  Severe allergic reactions can progress to a condition called “anaphylaxis” which can be fatal.


The measles rash would typically start with gradual onset of cold-like symptoms, cough, and watery eyes.  It is more common in un-immunized children.  Some people do react to alcohol, but that would be rare especially if they have had alcohol before and have never had a problem.  A heat rash more often affects infants though it can affect adults.  Heat rash causes red bumps on the skin and can occur during hot, humid weather.

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