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Other Reactions from Gloves
Published in Robert N. Phalen, Howard I. Maibach, Protective Gloves for Occupational Use, 2023
T. Bullock, A. Sood, J.S. Taylor
Pressure urticaria and cholinergic urticaria associated with glove use should be diagnosed by the patient's history and cutaneous examination.48 Armstrong et al.6 reported a case of glove-related urticaria of the hands in a hospital worker who did not have type I allergy to latex or type IV hypersensitivity to rubber chemicals. The patient developed a dermographic urticarial response whenever she scratched her hands while wearing the gloves; dermographism could also be elicited at other skin sites. A diagnosis of glove irritation leading to a secondary dermographic response was made. Thomson et al.7 reported three healthcare workers with a history of itching and inflammation of hands related to latex glove use; localized dermographism could be demonstrated in all patients. Patch and prick testing to latex was negative. The dermographism was thought to be precipitated by pressure or shearing forces produced by the recurrent application and removal of tight-fitting surgical gloves.
General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Dermatographia (also called dermographism or “skin writing”) appears warm in infrared images. If the scratched or otherwise traumatized skin becomes red and elevated, it is called red dermographism, which is a diagnostic finding of physical urticaria. If the site becomes white, it is called white dermographism; this is usually seen in patients with atopic dermatitis.59 Whether thermography can discern white from red dermographism remains to be studied.
Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A female patient suffered from generalized urticaria. The cause was suspected to be menthol in cigarettes, mint candies, mentholated cough drops, a mentholated aerosol room spray, and liberal applications of a mentholated topical petrolatum product. She also regularly used a facial cream containing menthol, and brushed her teeth twice daily with a mint-flavored toothpaste. The patient was advised to avoid all sources of mint and menthol and the lesions disappeared within 2 days and she was completely free of hives. Two weeks later the patient experienced a single episode of hives which was subsequently traced to an “instant” iced tea preparation containing mint flavoring. A single attempt to reinstitute the use of a mint-flavored toothpaste resulted in an immediate flushing and a general burning sensation. An open test with peppermint oil gave some burning and erythema after 15 minutes, but also in controls. A skin prick test reaction was the same as in 2 controls. However, an oral provocation test with menthol in alcohol induced a warm flushed feeling, a mild frontal headache, a single urticarial wheal on her arm and mild general pruritus. Dermographism could be demonstrated. At two hours all symptoms had subsided. A positive basophil degranulation test to menthol showed, according to the authors, hypersensitivity to menthol with circulating antibodies (31).
Mastocytosis and related entities: a practical roadmap
Published in Acta Clinica Belgica, 2023
Michiel Beyens, Jessy Elst, Marie-Line van der Poorten, Athina Van Gasse, Alessandro Toscano, Anke Verlinden, Katrien Vermeulen, Marie-Berthe Maes, J. N. G. Hanneke Oude Elberink, Didier Ebo, Vito Sabato
The diagnosis of CM relies mainly on recognition of (typical) skin lesions. A positive Darier’s sign serves as a major criterium. This involves a local wheal and flare reaction when lesions are stroked at moderate pressure. Darier’s sign differs from dermographism, since the latter also applies to nonlesional skin. Obviously, intake of antihistamines might result in a false-negative Darier’s sign. It is dissuaded to test Darier’s sign in patients with mastocytoma or the nodular variant of polymorphic MPCM as this can provoke flushing or even hypotension. However, this sign can be negative in adults with (cutaneous) mastocytosis but will often be positive in children [14]. The first two minor criteria are based on the skin biopsy. The first being an increased number (four- to eightfold) of MCs on histology. It is of note that the normal range value of MCs in skin is highly dependent on the site of biopsy and that some patients with CM do not have an increased number of MCs in the skin [15]. The second minor criterion is the presence of an (activating) KIT mutation in lesional skin tissue.
Efficacy and safety of bilastine in reducing pruritus in patients with chronic spontaneous urticaria and other skin diseases: an exploratory study
Published in Journal of Dermatological Treatment, 2020
Esther Serra, Cristina Campo, Zoltan Novák, Bernadetta Majorek-Olechowska, Grazyna Pulka, Aintzane García-Bea, Luis Labeaga
Main exclusion criteria included: patients with, or with a history of, malignant tumors, or patients with severe concomitant diseases including diseases of the liver, kidney, thyroid, and heart, hematological diseases (e.g. pancytopenia, leukopenia), psychiatric/neurological disorders and autoimmune diseases; patients with fungal, bacterial or viral skin infections (excluding those not interfering with the efficacy evaluation); patients with a history of non-responsiveness or allergy to antihistamines; and patients with diseases that might interfere with efficacy evaluation: cholinergic, physical, paraneoplastic, parasitic, or pigmented urticaria, angiitis or collagen disease induced urticaria, severe dermographism, Schnitzler syndrome, cryopyrin-associated periodic syndrome, and psoriasis; pregnant women, nursing mothers, and patients not using a reliable method of contraception. Patients who were treated with antihistamine, anti-allergic, antipruritic or anti-plasmin drugs, glycyrrhizinate or diamino diphenyl sulfone within 7 days of enrollment; or with systemic corticosteroids, immunological drugs (e.g. methotrexate, cyclophosphamide), P-glycoprotein inhibitors, or tacrolimus hydrate within 30 days prior to enrollment, were also excluded.
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
Skin prick testing was carried out in the following way: an allergen solution (2.0% latex; Institute of Immunology Zagreb, Croatia) was applied with standardized pipette as a droplet to the volar side of the forearm cleaned in advance with a large cotton ball and alcohol. The skin was then penetrated through the solution using a standardized lancet at an angle of 90°. The test began with the application of histamine (Institute of Immunology Zagreb, Croatia) as the positive control; a buffer (Institute of Immunology Zagreb, Croatia) was used as the negative control. A reaction was analyzed after 15–20 min by one medicine doctor with 15 years of experience. A weal larger than 3 mm in diameter (with a negative buffer solution and a positive reaction to histamine) was considered a positive result. The respondents who showed no reactions to the positive control and those with dermographism were eliminated from further work-up.