It is very important that you contact your prescribing doctor immediately. Reducing your Medrol (methylprednisolone) dose can sometimes cause a return of inflammation, leading to your current symptoms of fever, cough, and a fast heart rate. Please do not adjust your steroid dose, doxycycline, or Allegra (fexofenadine) on your own. Continue to monitor your oxygen levels closely. While 95% to 96% is acceptable, you should seek urgent medical care if your oxygen drops below 92%, or if you experience worsening shortness of breath or chest pain. Your doctor will likely need to adjust your medication taper safely.

Since it has lasted four days without improvement despite taking azithromycin, it is very important to see a doctor for an in-person evaluation. Because azithromycin is an antibiotic, it won't help if your infection is viral, such as mononucleosis, or if it is caused by a resistant bacterial strain. A healthcare provider can perform a quick throat swab to check for strep throat. To help you feel more comfortable in the meantime, you can gargle with warm salt water and take over-the-counter pain relievers like ibuprofen or acetaminophen.

Since fexofenadine (Allegra) is no longer helping, you might try cetirizine or loratadine, which are effective, daily non-drowsy antihistamines. The skin darkening you are experiencing is likely post-inflammatory hyperpigmentation, a common and temporary response to skin inflammation and scratching that typically fades once the itching stops. To soothe your skin, cool compresses or a mild hydrocortisone cream can help. Consult a healthcare provider to safely adjust your treatment and ensure you find lasting relief.

Hand, foot, and mouth disease typically resolves within 7 to 10 days, and the rash spreading can be a normal part of the process before it heals. While it is wonderful his fever has subsided, his continued vomiting is important to address. Because vomiting can lead to dehydration in a 17-month-old, please contact his pediatrician for a quick evaluation. In the meantime, continue the hydroxyzine (Atarax) and calamine to keep him comfortable, and offer small, frequent sips of fluid.

Yes, circumcision is widely considered the most definitive and highly effective treatment for chronic balanoposthitis. By removing the foreskin, it eliminates the warm, moist environment where inflammation and infections thrive, resolving symptoms in the vast majority of cases. Before proceeding, I highly recommend consulting a urologist to ensure there are no underlying conditions, like diabetes, contributing to the inflammation. This is a very common, routine procedure that offers excellent relief and can greatly improve your comfort and quality of life.

Since your symptoms resolve with fasting but return when you stop antihistamines like hydroxyzine, levocetirizine, or fexofenadine, we should consider conditions like chronic spontaneous urticaria, a specific food allergy, or histamine intolerance. I reassure you that we can manage this. I highly recommend keeping a detailed food and symptom diary and consulting an allergist or immunologist. They can safely guide you through a supervised elimination diet and help you find a long-term management plan so you don't have to rely solely on daily antihistamines.