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Clinical Testing of Occupational Glove Sensitivity
Published in Robert N. Phalen, Howard I. Maibach, Protective Gloves for Occupational Use, 2023
Obviously, a significant number of glove-related occupationally induced cases of contact urticaria and contact dermatitis could be substantially reduced if the presence of important allergens could be reduced or eliminated. This is particularly important as patients with glove dermatitis are predominantly young. For proteins, washing the gloves after molding, before they are dried, and steam sterilization, may decrease or even suppress immediate-type allergenicity.85 With regard to additives such as thiuram derivatives and carbamates, the release of which can be measured, their presence should also be reduced to a minimum and, perhaps, even be restricted by law.86 For people allergic to glove materials, allergen alternatives are available,16,87,88 although apparently the labels placed on gloves cannot always be relied upon.87 The glove manufacturing industry has through the years developed new glove manufacturing processes, e.g. low-protein natural rubber gloves, vulcanization accelerator-free gloves, and specific-purpose gloves containing antimicrobial agents and moisturizers.89 Switching from conventional medical single-use rubber gloves to accelerator-free rubber gloves improves occupational hand eczema, and some patients may even become completely free of symptoms.90
Immediate Contact Reactions (Contact Urticaria)
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Topical drugs that have been reported to cause immediate contact reactions (contact urticaria) are shown in table 5.1. The entire spectrum of symptoms and signs of the contact urticaria syndrome can result from reactions to drugs including erythema and wealing, localized urticaria, generalized urticaria, gastrointestinal symptoms, pulmonary symptoms, drop in blood pressure, and anaphylactic shock (12,83). Not included are cases where drugs applied to non-intact skin (e.g. leg ulcers) caused signs of immediate-type hypersensitivity (e.g. anaphylactic shock) without local contact urticaria, and where the diagnosis was made by scratch, prick or intradermal tests (e.g. refs. 59,60,61). In other words, the occurrence of contact urticaria from local application to intact skin, either in the clinical or the diagnostic setting, is a prerequisite for topical drugs to be included in table 5.1 The references provided are or may be examples of cases of immediate contact reactions, that the author came across while writing this book; a full literature review was not attempted.
In vivo testing
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Contact urticaria is defined as whealing, erythema, and pruritus developing within minutes after cutaneous or mucosal contact with the causative agent, usually clearing completely within 24 hours [72]. In distinction to delayed hypersensitivity reactions, these reactions are presumably IgE mediated. Raw foods are commonly incriminated, although similar reactions to chemicals, such as dyes in clothing, also can occur [73]. Patch testing may be negative or result in slow development of a wheal, whereas prick testing is frequently positive [74].
Skin reactions to latex in dental professionals – first Croatian data
Published in International Journal of Occupational Safety and Ergonomics, 2019
Iva Japundžić, Liborija Lugović-Mihić
In view of pathomechanism, reactions to latex can be of an allergic or non-allergic type [2,3]. Particularly frequent is contact urticaria – the most common allergic reaction in medical workers who use latex gloves [1,2]. This type of skin reaction to latex is mediated by IgE antibodies (type I) [1–3]. Contact urticaria occurs as a localized erythema and edema, usually starting within an hour and receding after several hours [3]. Aside from such immediate hypersensitivity reactions, those caused by delayed hypersensitivity (mediated by T cells, type IV) are also possible (e.g., allergic contact dermatitis). Still, the delayed type of allergic hypersensitivity is rarely evidenced when contact skin reactions are concerned [4]. More frequent is non-allergic contact dermatitis (irritant or toxic), very common in medical workers (physicians, nurses, dentists, lab technicians, etc.), mostly due to frequent hand washing and use of soap, aggressive disinfectants and detergents, glove use, etc. [5].
Bilastine: a lifetime companion for the treatment of allergies
Published in Current Medical Research and Opinion, 2020
Martin K. Church, Marysia Tiongco-Recto, Erminia Ridolo, Zoltán Novák
The EAACI/GA2LEN/EDF/WAO guidelines recommend second-generation H1-antihistamines at licensed doses as first-line therapy for patients with urticaria and suggest increasing the dose by two- to four-fold in patients who are unresponsive to the licensed dose7. The efficacy and safety of a bilastine updosing strategy has been demonstrated in two studies. In a randomized, crossover trial in patients with cold contact urticaria, the standard dose of 20 mg was effective at reducing the critical temperature threshold at which symptoms occurred, and efficacy was increased further when the dose was increased to 40 mg and 80 mg, such that 60% of patients were symptom-free when treated with the highest dose (Table 2)45.
Skin diseases of the vulva: eczematous diseases and contact urticaria
Published in Journal of Obstetrics and Gynaecology, 2018
Freja Lærke Sand, Simon Francis Thomsen
The diagnosis of vulvar contact urticaria caused by either latex or human seminal plasma should be based on history and demonstration of relevant specific IgE antibodies in serum or by skin prick test. An important differential diagnosis of allergic contact urticaria is chronic inducible urticaria, specifically symptomatic dermographism and delayed pressure urticaria with angio-oedema. These inducible urticarias develop reproducibly after repeated physical stimuli such as pressure and rubbing of the skin, and may therefore develop during or immediately after sexual intercourse or vaginal instrumentation.