ABSTRACT
Contact urticaria, is characterized by an urticarial wheal-and-flare reaction at the site of contact by an allergen. Immunological contact urticaria, while less common than non-immunological contact urticaria, has more potentially serious consequences, and therefore, its recognition and treatment is important. Immunological contact urticaria is a type I hypersensitivity reaction. Potential complications include organ system involvement other than skin and even anaphylaxis and death. A vast majority of immunological contact urticaria is work-related. We will discuss the definition of immunological contact urticaria, the mechanism of the contact urticarial reaction, contact urticaria in the occupational setting, and the role of grains in contact urticaria. Testing and treatment are also briefly discussed.