Ketorolac eye drop induced allergic wheal and chemosis.

Ketorolac is a non-steroidal anti-inflammatory drug which is prescribed rampantly in the treatment of seasonal allergic conjunctivitis due to its clinical efficacy of providing rapid relief from symptoms of allergy. There is a potential for cross sensitivity to aspirin. Hence, a leading question on aspirin allergy must be taken before prescribing the drug ketorolac.

Management of chronic urticaria in Asia: 2010 AADV consensus guidelines

This guideline is a result of a consensus reached during the 19th Asian-Australasian Regional Conference of Dermatology by the Asian Academy of Dermatology and Venereology Study Group in collaboration with the League of Asian Dermatological Societies in 2010. Urticaria has a profound impact on the quality of life in Asia and the need for effective treatment is required. In line with the EAACI/GA2LEN/EDF/WAO guideline for the management of urticaria the recommended first-line treatment is new generation, non-sedating H1-antihistamines. If standard dosing is ineffective, increasing the dosage up to four-fold is recommended. For patients who do not respond to a four-fold increase in dosage of non-sedating H1-antihistamines, it is recommended that therapies such as H2-antihistamine, leukotriene antagonist, and cyclosporine A should be added to the antihistamine treatment. In the choice of second-line treatment, both their costs and risk/benefit profiles are the most important considerations.

Pathogenesis of Contact Urticaria Induced by Nettle(Urtica Thunbergiana) / 대한피부과학회지

BACKGROUND: Nettles, of the plant family Urticae, cause nonimmunologic contact urticaria by stinging hairs. Light application of the leaf or stem to the skin results in the rapid development of a short-lived stinging sensation accompanied by wheal formation and itching. The types of chemical mediators causing the stinging sensation and wheal have not yet been clarified. OBJECTIVE: To investigate stinging and urticating substances causing contact urticaria when the skin is in contact with nettle(Urtica thunbergiana). METHODS: Twenty two volunteers were used for the clinical portion of this investigation. The time to wheal development and the evanescent time of pain and wheal were measured after pricking the forearm skin with nettle trichomes, following the administration of antihistamine, antiserotonin or corticosteroid, respectively or a combination of two, either with or without the application of substance P antagonist(capsaicin cream, 0.025%). Nettle extracts were prepared from dry stems and leaves of Urtica thunbergiana. Histamine, serotonin and substance P(SP) contents of nettle extracts were measured by gas chromatographic mass spectroscopy. RESULTS: After puncture of the skin by trichome of nettle, a stinging sensation developed within a few seconds but disappeared faster at the site where capsaicin cream had been applied than at the nonapplied skin site(p<0.05). The development and evanescent time of wheal were not significantly correlated with the application of capsaicin cream. The evanescent time of pain after pricking the skin with trichome following the administration of antiserotonin was significantly shortened at the nonapplied skin site. Pain disappeared more rapidly at the capsaicin applied site following the administration of antihistamine or antiserotonin than at the nonapplied sites(p<0.05), but not following prednisolone administration. Wheal development was delayed significantly at both the capsaicin applied and nonapplied sites after antihistamine administration(p<0.05). Histamine was detected only in the nettle extract. SP and serotonin were not detected because of their insolubility in solvents. CONCLUSION: These results suggest that wheal-and-flare reaction to nettle stings is due primarily to the histamine and partly to the serotonin and SP introduced by the nettle. SP may be mainly involved and partially involved by serotonin in stinging pain.

Substance P and VIP = induced Flare and Wheal Responses in Normal Healthy Persons / 대한피부과학회지

BACKGROUND: Despite concern about information of neuropeptide, the has been no baseline study of neuropeptide in Koreans. OBJECTIVE: The purpose of the study was to investigate the skin sinsitivity of substance P and VIP in normal healthy persoas. METHODS: We prepared 1000pM, 100pM, 10pM solution of substan P 1-11, substnace P 1-7, substnace P 7-11, and VIP. We injected intradermally 50ul of the br ve solutions on 12 sites of both forearms in addition plaebo. We measured the size of the area of flare and wheal along time. We repeated the same test after antihistamine intake. RESULTS: Flare and wheal respinses were dose dependent. Injection of substance P 1-7 did not evoke wheal responses and injection of substance P 7-11 did not wake flare responses. Flare responses of substance P 1-11, ubstance P 7-11, VIP were inhibiteb antihistamine and wheal responses of VIP were inhibitedly antihistamine. CONCLUSION: N-terminal of subtance P is responsible for flarers onses and C-terminal of substnace P is responsible for wieal responses. Flare responses of sisance P were mediated by histamine but wheal responses osubstance P were direct effect on postcapillary venule. Flare and wheal responses of VIF were mediated by histamine.