Contact urticaria

Fig.19.3,19.4) Contact allergy Contact urticaria Methaemoglobinaemia Hypotension... 

True IgE-mediated anaphylactic reactions to LAs are extremely rare [11-13]. Only single cases have been reported in the literature with positive prick tests [ 14,15]. A case of a positive open patch test in a patient suffering from contact urticaria after topical application of lidocaine, pilocaine mixture (Emla cream) might represent a true IgE-mediated allergy [16]. The maj ority of immediate-type reactions are non-immune in nature. 

Waton J, Boulanger A, Trechot PH. Schmutz JL. Barbaud A Contact urticaria from Emla cream. Contact Dermatitis 2004 51 284-287. 

Vega, J. et al., Occupational immunologic contact urticaria from pine processionary caterpillar (Thaumetopoea pityocampa) experience in 30 cases, Contact Dermatitis, 50, 60, 2004. 

Tarvainen, K. et al., Immunologic contact urticaria due to airborne methylhexahydrophthahc and methyltetrahydrophthahc anhydrides, Contact Dermatitis, 32, 204, 1995. 

Yokota, K. et al., Occupational contact urticaria caused by airborne methylhexahydroph-thalic anhydride, Ind. Health, 39, 347, 2001. 

Sensitiser by inhalation exposure (and/or causes immunological contact urticaria)... 

Maibach H, Johnson HL Contact urticaria syndrome. Dermatol 111 726-730, 1975... 

Helander I, Makela A Contact urticaria to zinc diethyldithiocarbamate (ZDC). Contact Derm 9 327, 1983... 

With respect to the shellfish meat, asthma and contact urticaria were reported in a restaurant worker from the handling of scallops (Goetz and Whisman, 2000). Inhalation of lyophilized clam in a factory producing freeze-dried clam was reported as a cause of occupational asthma (Desjardins et al, 1995). Occupational asthma has also been linked... 

Contact urticaria from Loligo japonica. Contact Dermatitis 35,367-368. 

Delgado, J., Castillo, R., Quiralte, J., Blanco, C., Carrillo, T. (1996). Contact urticaria in a child from raw potato. 

Jeannet-Peter, N., Piletta-Zanin, P. A., Hauser, C. (1999). Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato. Am. J. Contact Dermat, 10,40 2. 

The use of bacitracin in the anterior nares may temporarily decrease colonization by pathogenic staphylococci. Microbial resistance may develop following prolonged use. Bacitracin-induced contact urticaria syndrome, including anaphylaxis, occurs rarely. Allergic contact dermatitis occurs frequently, and immunologic contact urticaria rarely. Bacitracin is poorly absorbed through the skin, so systemic toxicity is rare. 

Sugiura K, Su giura M, Hayakawa R, et al. 2000. Di(2-ethylhexyl) phthalate (DOP) in the dotted polyvinyl-chloride grip of cotton gloves as a cause of contact urticaria syndrome. Contact Dermatitis 43 237-238. 

Suberythematous irritation Allergic contact dermatitis Photoallergic contact dermatitis Contact urticaria... 

Before confirming a diagnosis of subjective irritation, patients must be patch tested and open tested to exclude allergic contact dermatitis and contact urticaria, respectively. Subclinical contact urticaria, in particular, mimics sensory irritation. 

Muizzuddin et al. recently studied contact urticaria in an attempt to define sensitive skin objectively.22 Skin responsiveness was assessed using balsam of Peru, which induces NICU. They found that individuals with self-assessed sensitive skin were more susceptible to NICU. This group was also more susceptible to stinging induced by lactic acid and stratum corneum barrier removal using tape stripping. 

The methods for assessing reactivity previously outlined are simple, convenient, inexpensive, and noninvasive or minimally invasive 6 However, cutaneous reactivity depends on many factors. None of the previous methods give a full picture of the characteristics of sensitive skin, only susceptibility of skin to irritants. Subtle manifestations of endogenous cutaneous conditions must still be clinically excluded. Exclusion of allergic contact dermatitis must still be performed by patch testing, exclusion of contact urticaria by open tests or PUT/ROAT, and exclusion of photoallergy by photopatch testing. 

Patch test and photopatch test — to rule out contact and photocontact allergy Immediate-type testing — to rule out contact urticaria... 

Lammintausta, K., Maibach, H.I., and Wilson, D., Mechanisms of subjective (sensory) irritation. Propensity to non-immunologic contact urticaria and objective irritation in stingers, Derm. Beruf. Umwelt., 36, 45—49, 1988. 

Bourrain, J.L., Amblard, P., andBeani, J.C., Contact urticaria photoinduced by benzophenones, Contact Dermatitis, 48, 45, 2003. 

Yesudian, P.D. and King, C.M., Severe contact urticaria and anaphylaxis from benzophenone-3 (2-hydroxy 4-methoxy benzophenone), Contact Dermatitis, 46, 55, 2002. 

Howard Maibach, M.D., is aprofessor of dermatology at the University of California, San Francisco and has been a long-term contributor to experimental research in dermatopharmacology and to clinical research on contact dermatitis, contact urticaria, and other skin conditions. 

Asthma and rhinitis secondary to inhalation of food (e.g., occupational asthma) IgE-mediated cutaneous reactions Immediate-onset reactions Acute urticaria or angioedma Contact urticaria Late-onset reactions Atopic dermatitis... 

Kanerva, L. and Vanhanen, M. 2001. Occupational allergic contact urticaria and rhinoconjunc-tivitis from a detergent protease. Contact Dermatitis 45(1) 49-51. 

Ale, S.I. andMaibach, H.1.2000. Occupational contact urticaria. In Handbook of Occupational Dermatology, L., Kanerva, P., Eisner, J.E., Wahlberg, and H.I. Maibach, Eds., pp. 200-216. Springer-Verlag, Berlin, Heidelberg, New York. 

Chlorpromazine is thought to have caused an immuno-logically mediated contact urticaria (7-11). 

Hannuksela M. Mechanisms in contact urticaria. Clin Dermatol 1997 15(4) 619-22. 

Substances meeting the criteria for classification as respiratory sensitizers may in addition cause immunological contact urticaria. Consideration should be given to classifying these substances also as contact sensitizers. Substances which cause immunological contact urticaria without meeting the criteria for respiratory sensitizers should also be considered for classification as contact sensitizers. 

There is no recognized animal model available to identify substances which cause immunological contact urticaria. Therefore, classification will normally be based on human evidence which will be similar to that for skin sensitization. 

Kulze A. and Greaves M. (1988) Contact urticaria caused by stinging nettles. Br. J. Dermatol. 119, 169-270. 

There are two main sensitization reactions-immedi-ate and delayed hypersensitivity. Immediate type hypersensitivity is the result of antibody-allergen interaction occurring in the skin the reaction that develops is known as allergic contact urticaria. Delayed type hypersensitivity is the result of cell-mediated immunity and is the most frequently reported side effect of topical drugs. Both epidermal and dermal cells play pivotal roles in irritation and sensitization. Keratinocytes... 

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