Drug allergies and hives are increasingly common conditions, often underestimated or mistaken for other bodily reactions. To shed light on this important topic, we interviewed Dr. Orazio Grimaldi, a specialist in allergology and clinical immunology at Ars Medica Clinic, who explained how to recognize, diagnose, and properly manage these conditions.

Dr. Grimaldi, what exactly is a drug allergy?

A drug allergy is an IgE-mediated reaction in which the immune system mistakenly identifies certain drug components as harmful, triggering an allergic response.

Which medications are most commonly involved?

Allergic reactions most frequently occur with antibiotics (especially penicillins and cephalosporins), nonsteroidal anti-inflammatory drugs (NSAIDs), and, in some cases, contrast agents or anesthetics.

It is important to note that individuals with a family history of allergies may be more prone to drug reactions, and these conditions often arise due to the widespread use of certain medications.

How does a drug allergy manifest?

Symptoms may appear within minutes or hours after taking the medication, but sometimes they emerge after several days.

The most common manifestations include hives, itching, skin redness, and swelling. In more severe cases, symptoms such as difficulty breathing or a drop in blood pressure (signs of anaphylaxis) may occur, requiring immediate medical attention.

Continuous use of a medication can also increase the risk of side effects.

It is crucial not to ignore the body’s warning signs and to consult an allergist promptly.

Is Hives Always a Sign of an Allergy?

Hives are sudden outbreaks of widespread itching and skin rashes, which can be triggered by a variety of factors, including allergic reactions. These may include temperature changes (hot or cold), persistent infections, foods, chemicals, medications, and more.

Recurrent episodes and the severity of the reaction guide the search for and diagnostic definition of the underlying cause of hives.

How Is an Accurate Diagnosis Made?

Diagnosis relies on a thorough clinical evaluation and targeted tests, which may include skin tests, blood analyses, diagnostic imaging (ultrasounds, CT scans, or MRI) in selected cases, and controlled provocation tests in a safe environment.

A key element in guiding the investigation is a detailed medical history, taken collaboratively between doctor and patient.

Once an Allergy Is Confirmed, How Is It Managed?

After diagnosis, identifying and avoiding the triggering substance is essential.

Today, we have precise tools and advanced tests to detect and treat allergies effectively. Consulting an experienced specialist and a multidisciplinary team is the first step toward restoring well-being, safety, and peace of mind.