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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of urticaria/angioneurotic oedema produced by alcoholic beverages are presented. In two of them, the causative agent was probably yeasts in wines. An intracutaneous test with Candida, a conjunctival provocation test with Candida, and peroral challenge tests with wines were positive in both cases. The symptoms disappeared when the patients went on a low-yeast diet. In the third case, ethanol itself and acetic acid apparently were the factors underlying urticaria. Peroral challenge tests with ethanol, brandy and acetic acid were positive, but those with acetaldehyde remained negative. The patient has been asymptomatic after giving up alcoholic drinks alone.
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PMID:Urticaria from alcoholic beverages. 94 40

It is possible in the majority of patients with polymorphic light eruption to produce lesions experimentally. Only the reproduction of the clinical reaction is significant for the diagnosis. Irradiation is carried out in the same test area two or three times with a dose of up to eight times the minimal erythema dose. Sunlight is the best agent for the evaluation of this protocutaneous disorder. A localised area of the skin can be exposed to midday sunshine about half an hour on three consecutive days. But sunlight has the disadvantage of having a variable ultraviolet emission at different times. It is necessary to differentiate lupus erythematosus and photocontact dermatitis, which may produce identical reactions. Other light sources are the hot quartz lamp, fluorescent tube "sun lamp", solar simulator and the monochromater. Patients with polymorphic light eruption are sensitive to light in the range 300 to 320 nm. but some of them are sensitive to savelengths shorter or longer than this range. The methods of protection against solar radiation which have been tried include: 1) Avoidance of sunlight; 2) Promotion of melanin hyperpgimentation and thickening of the stratum corneum-by controlled exposure to sunlight; 3) Application of a film of a chemical compound that will act as a physical screen and absorb, scatter or reflect damaging radiation; 4) Chemical modification of the stratum corneum by topically applied substances which can conjugate chemically or be absorbed onto the stratum corneum and filter the damaging rays. Many authors at present consider the use of alcoholic solutions of para-aminobenzoic acid (PABA) to be the most effective method of preventing reactions from exposure to sunlight. Pathak and Fitzpatrick showed that 5 % PABA in 70 % ethanol and 2,5 % Escalol 506 in 65 % ethanol is the most effective sunscreen against radiation of the sunburn spectrum. A dihydroxyacetone (DHA) and naphthaquinone (lawsone) sunscreen provides photoprotection for all types of photosensitivity throughout the whole UV spectrum even into the visible region. Systemic photoprotection: The administration of beta-carotene to patients with erythropoietic protoporphyria has resulted in amelioriation of their photosensitivity. Antimalarials are valuable therapeutic agents and are highly effective in controlling cutaneous lupus erythematosus, polymorphic light eruption and occasionally solar urticaria.
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PMID:[Polymorphic light dermatitis. Photobiology and photoprotection]. 98 44

This review of the research and development of transdermal delivery systems for levonorgestrel and combinations of levonorgestrel and estrogens also contains explanatory material on skin structure and absorption of drugs by diffusion and partition, permeability and use of enhancers to facilitate absorption, use of pro-drugs and derivatives, and cutaneous side effects. Drug absorption entails diffusion through the lipophilic stratum corneum and the hydrophilic epidermis, and between the two layers. Diffusion of levonorgestrel is driven by the saturated solution in the medium, such as ethanol, but the rate was insufficient. The target delivery rate for levonorgestrel used alone as a contraceptive is 35 mcg/day for transdermal use, which would require a delivery rate of 0.3 mcg/sq.cm. Ethyl acetate was found to be the best "penetration enhancer," speeding absorption 17-fold in rat skin. Levonorgestrel in ethyl acetate diffused through human cadaver skin at a rate requiring a patch of 7.5 sq. cm. Use of pro-drugs and derivatives is based on the theory that even though the derivative may diffuse more slowly because of its larger size, it is more soluble in both lipophilic and hydrophilic media. The best pro-drug was levonorgestrel-glycidol, with a 32-fold increase in penetration. Pro-drugs have the drawback of requiring complete FDA approval. They are hydrolyzed in skin to the native steroid, however. The type of transdermal delivery system needed for levonorgestrel is a membrane-based patch with a reservoir. Ethylene vinyl acetate copolymer systems have been tested or rabbits and in Phase I clinical trials. The micro-reservoir systems has been marketed for estradiol in a 3.5-day patch. A similar system has been developed experimentally using levonorgestrel and estradiol combined. Most transdermal systems cause mild skin irritation in a high proportion of users, but the likelihood of contact allergy or urticaria with levonorgestrel is minimal. Development of a transderm system with levonorgestrel and ethyl acetate, which is generally recognized as safe (GRAS), would be feasible as soon as the stability of levonorgestrel in ethyl acetate is defined.
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PMID:Transdermal delivery of levonorgestrel. 189 13

This comprehensive review of transdermal delivery systems for estrogens and progestins covers skin structure and absorption of chemical agents by diffusion and partition, permeability and use of enhancers to speed absorption, choices of drugs for transdermal contraceptives, animal and clinical work with estradiol, ethinyl estradiol and levonorgestrel, use of pro-drugs and derivatives, types of transderm delivery systems, metabolism of these drugs by skin and skin flora, and cutaneous side effects, all illustrated graphically and mathematically. Drug absorption entails diffusion through the primarily and mathematically. Drug absorption entails diffusion through the primarily lipophilic stratum corneum, and the hydrophilic epidermis: transport between these layers is often the rate-limiting step. For many drugs, permeability enhancers such as dimethyl sulfoxide, ethanol and ethyl acetate are needed. Good drug candidates for transdermal application must be potent in low doses, have short half-lives, not elicit an allergic response nor be extensively metabolized in skin. The permeability of levonorgestrel has been increased by using esters, and "pro-drugs" which are compounds that increase polarity, but are degraded to the active drug by skin tissue. The estrogens are subject to a minor degree of oxidation, and no significant degradation by skin microbes. There are 3 types of transdermal systems: the membrane, matrix and drug reservoir types. The Estraderm brand system for estradiol is a membrane-moderated design with ethanol as the chemical enhancer. Skin penetration is the rate-limiting step. Levonorgestrel as been tested with ethyl acetate and ethanol as penetration enhancers in rats, rabbits, and in a Phase I trial. The development of a transderm system for a combination of estrogen and progestin is a complex problem because 2 different enhancers must be used. Most transdermal systems are mild skin irritants, but incidence of contact allergy or urticaria are rare, with no cases yet reported from use of Estraderm. Transdermal application of contraceptive steroids is expected to be available eventually.
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PMID:Transdermal delivery of contraceptives. 227 99

Astemizole is a potent H1-antagonist devoid of sedative effects, which was found at single oral daily doses to be very effective in the treatment of allergic rhinitis, allergic conjunctivitis, and urticaria. Its interaction potential on other drugs was studied in various ways. Studies on salivary antipyrine clearance, the 6-beta-hydrocortisol excretion, the elimination rate of ethanol and the indocyanine-green clearance are presented. No changes were observed. Astemizole also was given in combination with diazepam or alcohol. Psychomotor performance failed to show any effects. In none of these studies was there any evidence of interaction of astemizole on other drugs. This review summarizes the data available thus far.
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PMID:Potential of interaction between the H1-antagonist astemizole and other drugs. 287 1

Urticaria, after ingesting ethanol, is rare. A 36-year-old Caucasian male developed multiple, generalized, pruritic urticarial lesions 5 to 15 minutes after drinking alcoholic beverages of any type. A blinded challenge with 5 mL of chemically pure 95% ethanol in concentrated grape juice caused urticaria and an elevation of plasma histamine. Pure grape juice alone was unreactive. Prick skin tests with Brewers' yeast, ethanol, acetaldehyde, and acetic acid were negative. Hydroxyzine (25 mg, p.o., q.i.d.), given for three days prior to challenge, inhibited skin response and histamine release. Biopsy of the urticarial lesions caused by ethanol ingestion showed mast cell degranulation. In this subject, ethanol appeared to directly affect mast cell mediator release by non-IgE mechanisms.
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PMID:Ethanol-induced urticaria: a case report. 338 58

In a retrospective analysis of 35 Black patients with chronic active hepatitis (CAH) admitted to Baragwanath Hospital, Johannesburg, during the period 1972--1980, four major aetiological categories were found: auto-immune (lupoid, immunological (57%)), drug induced (isoniazid and alpha-methyldopa (17%)), hepatitis B virus-related (14%), and alcohol-related (11%) CAH. Alcohol-related CAH was found in males only. Upper abdominal pain was a presenting feature of alcohol-induced CAH, while jaundice was a common, presenting feature of the other types. Systemic features such as skin rashes (acne, urticaria), bacterial infections and congestive cardiac failure were prominent in the auto-immune type of CAH. The liver was enlarged in the majority of cases. Hepatitis B virus-related CAH showed an absence of tissue nonspecific auto-antibodies. Cirrhosis was present in approximately 50% of patients at the time of diagnosis. Despite the facts that isoniazid and alpha-methyldopa are commonly used and hepatitis B infections and alcohol abuse are frequent in this population, CAH remains an uncommon condition in South African Blacks.
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PMID:Chronic active hepatitis at Baragwanath Hospital. 684 59

In two patients urticaria was elicited by contact with nickel-containing objects. Chamber-prick test with nickel sulfate 2.5% in pet. evoked a strong urticarial reaction in both patients. In one of the patients contact with plastic articles also provoked urticaria. A 20-min patch test with several articles of plastic (polyethylene and PVC) and with butylhydroxytoluene (BHT) 1% in ethanol elicited urticarial reactions. BHT is used as an antioxidant in plastic. Furthermore, open patch test with oleylamide (amide of oleic acid) 0.1% in ethanol elicited a strong urticarial reaction in 20 min. This chemical is used as a slipping agent in plastic.
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PMID:Contact urticaria from nickel and plastic additives (butylhydroxytoluene, oleylamide). 721 87

An 11-yr-old girl presented with a history of urticaria induced by warm or cool showers, exercise, and emotional stimuli. During evaluation she repeatedly developed generalized punctate urticaria, pruritus, palpitations, and headaches after warm baths or exercise, and she had a positive methacholine skin test. She developed similar lesions and pruritus after local application of sterile water, tap water, ethanol, normal saline, or 3% saline. The diagnosis of combined aquagenic and cholinergic urticaria was made and presented a unique opportunity to study and compare mediator release and clinical symptoms in both conditions. The patient was submerged in bath water at either 37 degree or 41 degree C to induce either aquagenic or cholinergic urticaria, respectively. Histamine was released into the systemic circulation in both conditions in a similar time course; however, systemic symptoms occurred only after the 41 degree C bath. After failure to induce tolerance to the 41 degree C bath water, hydroxyzine therapy was instituted. One week later she was rechallenged; few symptoms appeared, and a rise in serum histamine was not detected as had been shown in previous challenges. The data suggest that in our patient, hydroxyzine may have contributed to the inhibition of both histamine release and the appearance of symptoms during hot bath challenging.
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PMID:Evaluation of a patient with both aquagenic and cholinergic urticaria. 731 13

A case of a hairdresser who developed an immediate-type hypersensitivity with urticaria, rhinitis, and bronchial asthma on exposure to henna is reported. Prick tests with henna 1% in aqua and in ethanol showed positive reactions. Both patch tests and prick tests performed with the dye in henna, lawsone, or 2-hydroxy-1, 4-naphtoquinone, which is supposed to be an allergen, had negative results. These results suggest that not only 2-hydroxy-1,4-naphtoquinone but also other still undetermined ingredients of the henna powder should be considered as possible allergen(s).
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PMID:Occupational immediate-type hypersensitivity to henna in a hairdresser. 879 40


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