Contact Urticaria Syndrome Treatment & Management

Updated: Dec 09, 2016
  • Author: Saqib Bashir, MBChB, MD, FRCP; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Approach Considerations

Patients need to be well versed in the nature of their urticarial reaction (immunologic vs nonimmunologic contact urticaria), in avoidance techniques, and in suitable alternatives.

Patients with immunologic contact urticaria should purchase medic alert tags delineating their allergies, 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.

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. [4]

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.

Inpatient care

Admission for medical care is not routinely indicated for contact urticaria syndrome. Patient transfer is also rarely indicated.

Follow-up

If a patient has immunologic contact urticaria, a follow-up visit to verify the patient's understanding of the condition may be indicated.

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Prevention

Affected patients should avoid exposure to trigger substances. A large cohort study following nearly 1000 healthcare workers found that latex-sensitized healthcare workers can reduce or eliminate cutaneous symptoms by wearing nonlatex gloves themselves and ensuring that their coworkers wear nonpowdered latex gloves (or, ideally, nonlatex gloves).

A policy of minimizing glove use and using only powder-free gloves prevented any new sensitizations in the 3-year study period. [37] However, patients with respiratory or systemic features may have to work in a completely latex-free environment.

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