Contact Urticaria Syndrome Treatment & Management

  • Author: Saqib Bashir, MB, ChB, MD, MRCP; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 11, 2012
 

Medical Care

  • Patients need to be well versed in the nature of their urticarial reaction (immunologic contact urticaria vs nonimmunologic contact urticaria), in avoidance techniques, and in suitable alternatives.
  • Patients with immunologic contact urticaria should purchase medic alert tags delineating their allergens, including potential cross-reacting substances.
  • Depending on the degree of reactivity and the ubiquity of the allergen, patients with immunologic contact urticaria may require antihistamines and self-administered epinephrine.
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Diet

Affected individuals should avoid foods and food products that trigger their symptoms. One should be aware that food extracts are sometimes used in cosmetics, which may lead to unintended exposure. Additionally, cross-reactivity of latex to foods such as banana, kiwi, and avocado may require additional avoidance.[2] However, advice regarding the avoidance of cross-reactive foods should be given after appropriate skin prick testing or a RAST because not all individuals are affected in this way.

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Activity

Affected patients should avoid exposure to trigger substances. A large cohort study following nearly 1000 health care workers found that latex-sensitized health care workers can reduce or eliminate cutaneous symptoms by wearing nonlatex gloves themselves and ensuring their coworkers wear nonpowdered latex gloves (or, ideally, nonlatex gloves). However, patients with respiratory or systemic features may have to work in a completely latex-free environment. A policy of minimizing glove use and using only powder-free gloves prevented any new sensitizations in the 3-year study period.[28]

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Contributor Information and Disclosures
Author

Saqib Bashir, MB, ChB, MD, MRCP  Consultant Dermatologist and Dermatological Surgeon, King's College Hospital, NHS Foundation Trust, UK; Research Fellow, Department of Dermatology, University of California, San Francisco, School of Medicine

Saqib Bashir, MB, ChB, MD, MRCP is a member of the following medical societies: British Association of Dermatologists, British Medical Association, Royal College of Physicians, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Howard I Maibach, MD  Professor and Vice Chairperson, Department of Dermatology, University of California School of Medicine at San Francisco; Consulting Staff, University of California Hospitals

Howard I Maibach, MD is a member of the following medical societies: American Academy of Dermatology, American College of Forensic Examiners, American College of Physicians, American Contact Dermatitis Society, American Dermatological Association, American Federation for Clinical Research, American Medical Association, California Medical Association, Pacific Dermatologic Association, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Donald Belsito, MD  Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center

Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, New York County Medical Society, New York Dermatological Society, Noah Worcester Dermatological Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Celgene Honoraria Safety Monitoring Committee

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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