Immediate Contact Reactions (Contact Urticaria)
Anton C. de Groot in 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.
Dermatotoxicology of Microneedles in Man
Boris Stoeber, Raja K Sivamani, Howard I. Maibach in Microneedling in Clinical Practice, 2020
Contact urticaria comprises a group of inflammatory reactions ranging from itching, burning, and tingling to systemic anaphylaxis (Gimenez-Arnau and Maibach 2014). Contact urticaria can be divided into NICU and ICU, the two separate entities being distinguished by immunologic memory in the case of ICU but no required prior sensitization in NICU (Gimenez-Arnau and Maibach 2014). The ICU and NICU are distinct in mechanism and etiology, but have very subtle, if any, difference in their clinical presentation (Gimenez-Arnau and Maibach 2014; Lahti 2000).
Diagnostic Tests in Dermatotoxicology
Francis N. Marzulli, Howard I. Maibach in Dermatotoxicology Methods: The Laboratory Worker’s Vade Mecum, 2019
Contact urticaria syndrome includes a group of skin reactions, i.e., immediate contact reactions, that usually appear within 1 hr of skin contact with the causative agent. Immediate skin reactions are divided into immunological (IgE-mediated) and nonimmunological immediate contact reactions. The symptoms range from mere itching and tingling to local wheal-and-flare. In cases of intense sensitivity, a generalized urticaria, systemic symptoms, and even anaphylaxis (contact urticaria syndrome) may occur (Lahti and Maibach, 1992).
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].
Does synthetic pharmacotherapy still have a place in treating chronic spontaneous urticaria?
Published in Expert Opinion on Pharmacotherapy, 2022
Rebecca M. Thiede, Mohammad Fazel, Karen M. MacDonald, Ivo Abraham
Chronic urticaria is an inflammatory disease driven by mast cells and characterized by spontaneous wheals (with individual lesions self-resolving in <24 hours) and/or angioedema for at least 6 weeks occurring in relation to known or unknown causes. Also known as hives, urticaria can be inducible or spontaneous. Inducible urticaria is characterized by the development of wheals, angioedema, or both in response to a specific external physical trigger and will not occur without this trigger: cold, heat, sunlight, pressure, exercise, contact with offending solid or liquid substances, including foods, plant and animal matters, water, chemicals, among others. In contrast, symptoms of spontaneous urticaria (also referred to as idiopathic urticaria) occur without known or identifiable external physical triggers [1]. Resolution of chronic urticaria, inducible or spontaneous, may take several months or years. Treatment is necessary to limit flares, reduce pruritus, and improve quality of life. Chronic urticaria affects both the objective functioning and subjective well-being of patients [2–4]. The 2014 approval of the monoclonal antibody omalizumab as an add-on therapy, as well as biological therapies currently being evaluated, raises the question of the role, if any, of synthetic agents.
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.
Related Knowledge Centers
- Allergic Rhinitis
- Asthma
- Fexofenadine
- Psychological Stress
- Rash
- Allergy
- Arthropod Bites & Stings
- Idiopathic Disease
- Patch Test
- Antihistamine