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

Latex allergy has reached epidemic proportions in the United States and is increasingly recognized as a significant contributor to morbidity and mortality during medical and surgical procedures. Ultimately, many of the affected patients with recognized latex sensitivity and those who are not yet diagnosed will receive treatment for their allergic reactions to latex in emergency departments. Consequently, emergency physicians must have a comprehensive understanding of the etiology, epidemiology, pathogenesis, treatment, and management of these challenging patients. Groups at high risk include spina bifida cystica patients, health care workers, latex industry workers, specific food-allergy patients, and patients with a history of atopy or multiple surgical procedures. Sensitization to latex antigens is commonly encountered in health care workers wearing latex gloves with high latex allergen concentrations and in workers using powdered latex surgical gloves. Exposure to air-borne allergens and water-soluble IgE reactive latex antigens from natural rubber latex products in sensitized individuals can result in type I (immediate) hypersensitivity reactions. Clinical manifestations include contact urticaria, dermatitis, allergic rhinitis, conjunctivitis, asthma, angioedema, and anaphylaxis. Diagnostic tools include serological assays and skin prick testing. At present, latex avoidance is the only available treatment and is the key to preventing allergic reactions in latex-sensitized individuals. Health care worker sensitization to latex antigens in natural rubber products is becoming an increasing contributor to workers' liability and disability claims. Specific action can be taken to reduce occupational and patient exposure to latex antigens.
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PMID:Natural rubber latex allergy: spectrum, diagnostic approach, and therapy. 901 91

We report a 68-year-old man who had immediate-type heat urticaria with systemic symptoms. Immersing his hand in water at 42 degrees C (heat challenge test) produced an urticarial response, with an increase in the plasma histamine level from 0.26 to 7.64 ng/mL. Administration of oral antihistamines alone did not suppress either the urticarial response or the increase in plasma histamine. However, a combination of antihistamines and desensitization improved the skin lesions and reduced the plasma histamine level. The heat challenge test subsequently provoked a negative response and there was no increase in plasma histamine level 3 months after starting the combination therapy. These results indicate that the histamine level reflected the result of the heat challenge test and the amelioration of the skin eruption.
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PMID:Immediate-type heat urticaria: report of a case and study of plasma histamine release. 960 84

Physical urticaria comprises a series of clinically differentiated conditions in which wheals develop as a result of physical stimuli: mechanical (friction, pressure), cold, heat, increased body temperature, exercise exposure to sunlight, vibration and contact with water. The present study reviews their clinical, diagnostic and treatment characteristics. Although the precise prevalence of physical urticaria is not know, it nevertheless represents the most common form of urticaria of known etiology in children. Symptomatic dermatographism is the most frequent presentation in children; it may be present from birth and persist indefinitely. In order to study the prevalence of dermatographism in our pediatric population, we randomly selected 238 children of both sexes (128 boys and 110 girls) aged 2 to 14 years, in the Paternal Health Care Center (Valencia, Spain). An evaluation was made of skin response 5 minutes after the application of pressure (3,200 g/cm2) along a 5-cm extent of skin on the back, using a dermatographometer. A positive response was considered when a wheal over 2 mm in diameter developed; in this context, the prevalence of dermatographism was 24%, with a significant predominance of females (33%) over males (16%). According to the data obtained from the anamnesis, 41% of the children with dermatographism referred exanthema in response to friction and pressure compatible with symptomatic dermatographism, versus only 5% of those who tested negatively. Lastly, 42% of the children with dermatographism referred intense local reaction (5 cm or more) in response to mosquito bites, versus only 16% of the children who tested negatively for dermatographism. The study of bronchial reactivity to metacholine in 17 children with dermatographism but no bronchial asthma (based on the Chatham method) proved positive in 13 cases (76%). Seven of these 17 children (41%) yielded positive skin tests (3 referred symptoms of rhinitis, with no manifestations of asthma in any case), and the metacholine challenge proved positive in 5 (71%). Ten of the children showed negative skin testing for aeroallergens - with positive metacholine testing in 8 (80%). These results indicate a high prevalence of bronchial hyper-responsiveness in children with dermatographism, suggesting the existence of an association between skin and bronchial hyper-reactivity. Skin tests with aeroallergens were made in 45 of the 58 children with positive dermatographism; 38% were found to be positive for at least one of the allergens studied, a figure that increased to 43% when only considering children over the age of 7 years. This points to a high prevalence of atopy among children with dermatographism. In order to evaluate the prevalence of dermatographism in the atopic population, we studied 100 patients in the 4-14 years age range suffering from respiratory pathology associated with sensitization to aeroallergens. A positive response to pressure (3,200 g/cm2) was observed in 47% of cases, this being significantly higher than the prevalence observed among the general pediatric population.
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PMID:[Round Table: urticaria with a physical cause]. 1035 12

A variety of environmental stimuli, such as vibration, ultraviolet radiation, and exposure to water, are recognized as causes of "physical urticaria." A medical student, participating in a demonstration of a galvanic device used in the treatment of hyperhidrosis, demonstrated urticaria in response to this galvanic stimulation.
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PMID:Galvanic urticaria. 1038 52

Hot water epilepsy is a reflex epilepsy. Seizures are provoked by hot water, and result from the association of both cutaneous and heat stimuli. Described mainly in India and Japan, the condition seems to be rare in Europe, where it occurs in young children. We report five infants aged from 6 months to 2 years. They had brief seizures during bathing with activity arrest, hypotonia, and vasoactive modification; clonic movements were observed. A simple treatment-decreasing the bath temperature-can be sufficient. Sometimes an antiepileptic drug is required. Seizure course and psychomotor development are favorable. Hot water epilepsy is a benign form of epilepsy. Its incidence could be underestimated because of confusion with febrile convulsions, vagal fits, or aquagenic urticaria.
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PMID:Hot water epilepsy: a benign and unrecognized form. 1069 97

A 30-year-old man with atopic dermatitis had had erythema and itching of the hands after washing rice in water, though he had always eaten cooked rice without problems. Handling test with water used to wash regular rice was performed on abraded hands, and produced urticarial erythema after several minutes. Applications of water used to wash allergen-reduced rice were negative for urticarial reaction. Prick test with water used to wash regular rice was +++. However prick test reaction with water used to wash allergen-reduced rice was +. Histamine-release test of regular rice-washing water was grade 3 and that of allergen-reduced rice grade 1. In immunoblotting analysis with regular rice washing water, there were no bands with this patient. These results suggest that the allergen responsible for contact urticaria in this patient might be water-soluble, heat-unstable, and not contained in allergen-reduced rice.
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PMID:Contact urticaria from rice. 1120 11

Despite treatment for malaria two travellers who acquired fever in Africa continued to have complaints: a 25-year-old Dutch woman and a 25-year-old Australian man. On questioning they appeared to have swum in Lake Malawi and a diagnosis of acute schistosomiasis was made, confirmed by serological tests. This syndrome, also called Katayama fever, is characterized by fever, oedema, urticaria and eosinophilia. The aetiology is not fully elucidated but it is supposed to be caused by immune complexes initiated by maturing worms and eggs. Patients who acquired fever in an endemic area must be questioned about contact with fresh water. Serological tests are important for the diagnosis. Treatment is with praziquantel but it is advised to treat only after the acute phase. During the acute manifestations corticosteroids may be necessary. Prevention is by avoiding contact with infected water. There is no vaccine. The role of artemisinin drugs in prevention is currently being studied.
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PMID:[Acute schistosomiasis: fever and eosinophilia, with or without urticaria, after a trip to Africa]. 1121 50

In dentistry, allergic contact dermatitis to acrylates and allergic contact urticaria to latex are important occupational hazards. There is a need to identify non-latex gloves which are suitable for dental work but at the same time provide adequate protection against acrylate monomers. In a previous study, a new open-chamber system was used for testing the in vivo protection of 6 different gloves against an acrylate-containing ethanol-based dental adhesive. A nitrile glove gave the best protection among the gloves suitable for dental work. In the present study, the test model was used to investigate the in vivo protection of 7 non-latex gloves against a dental bonding product containing 2-hydroxyethyl methacrylate (2-HEMA) in an acetone/water vehicle. Eight 2-HEMA-allergic patients participated. Two neoprene gloves gave the best protection. The protection of the poorest glove was comparable to that of the positive control (no glove). The study produced in vivo data useful in the implementation of individual preventative measures against contact allergy to acrylates.
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PMID:In vivo testing of the protection provided by non-latex gloves against a 2-hydroxyethyl methacrylate-containing acetone-based dentin-bonding product. 1124 38

The treatment of cryptosporidiosis has focused primarily on controlling its main symptom, diarrhea. Cryptosporidiosis is found in 10 to 20 percent of people with AIDS who have diarrhea, and as many as 45 million people are exposed to it every year through municipal water systems. Nitazoxanide (NTZ) is an anthelminthic drug that has been available for several years in developing countries where tapeworm and liver fluke infestations are common, and physicians in Texas sometimes prescribe it because it is readily available in Mexican pharmacies. NTZ has not yet been approved in the United States, although Unimed Pharmaceuticals has submitted a New Drug Application for the drug. Results of several clinical trials are presented. Side effects associated with NTZ are rare, but include decreased liver function, discolored urine, and hives. Drug interaction studies have not been completed. Other treatments are reviewed, and information is provided for drug availability and Unimed's expanded access program.
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PMID:Nitazoxanide for cryptosporidial diarrhea. 1136 64

Skin testing with a suspected drug has been reported to be helpful in determining the cause of cutaneous adverse drug reactions (CADR). Many isolated reports of positive drug skin tests are published, but without detailed information concerning the clinical features of the CADR and the method used in performing drug skin tests, such data are not very informative. A working party of the European Society of Contact Dermatitis (ESCD) for the study of skin testing in investigating cutaneous adverse drug reactions, has proposed the herein-reported guidelines for performing skin testing in CADR in order to standardize these procedures. In each reported case, the imputability of each drug taken at the onset of the CADR and a highly detailed description and characterization of the dermatitis need to be given. Drug skin tests are performed 6 weeks to 6 months after complete healing of the CADR. Drug patch tests are performed according to the methods used in patch testing in studying contact dermatitis. The commercialized form of the drug used by the patient is tested diluted at 30% pet. (pet.) and/or water (aq.). The pure drug is tested diluted at 10% in pet. or aq. In severe CADR, drug patch tests are performed at lower concentrations. It is also of value to test on the most affected site of the initial CADR. Drug prick tests are performed on the volar forearm skin with the commercialized form of the drug, but with sequential dilutions in cases of urticaria. Intradermal tests (IDT) are performed with sterile sequential dilutions (10-4, 10-3, 10-2, 10-1) of a pure sterile or an injectable form of the suspected drug with a small volume of 0.04 ml. Drug skin tests need to be read at 20 min and also later at D2 and D4 for patch tests, at D1 for prick tests and IDT. All these tests also need to be read at 1 week. The success of skin tests varies with the drug tested, with a high % of positive results, for example, with betalactam antibiotics, pristinamycin, carbamazepine and tetrazepam on patch testing, or with betalactam antibiotics and heparins on delayed readings of IDT. The results of drug skin tests also depend on the clinical features of the CADR. The use of appropriate control patients is necessary to avoid false-positive results.
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PMID:Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. 1184 46


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