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.
ABSTRACT
Particular types of eczema may affect up to 29% individuals in certain populations (lifetime prevalence), thus placing the diseases among most frequent clinical problems. Nevertheless, diseases from the spectrum of dermatitis and eczema are poorly defined and frequently misdiagnosed; they also frequently overlap, making the diagnostic process even more difficult. In doubtful cases, where no further means of clinical or laboratory differentiation are available, reliable epidemiological data may provide relevant help in the diagnostic process, as the best candidate for a tentative diagnosis seems the most frequent among diseases in question, which can be verified later by the effectiveness of respective treatment regimen. However, results of epidemiological studies in the field of eczema and dermatitis may be strikingly contradictory, one of the possible reasons being definitions of various types of eczema/dermatitis that leave too much space for individual decision and thus seem hardly suitable for epidemiological research. Better studies based on unequivocal definitions of various types of eczema are necessary to achieve the quality of epidemiological data that would ensure the level of certainty expected from a diagnostic tool. The present paper collates results from available epidemiological data on various types of eczema: atopic eczema, allergic and irritant contact dermatitis, protein contact dermatitis, seborrhoeic dermatitis, asteatotic dermatitis, stasis dermatitis, nummular eczema, dyshidrotic eczema (pompholyx), hand dermatitis and occupational dermatitis. Problems and possible sources of bias in available studies are addressed and discussed along with the results from the studies.
ABSTRACT
A 24-year-old woman complained of chronic eczematous lichenified skin lesions with itching on both hands. The lesions were distributed mainly on the lateral and dorsal sides of the fingers. She had a history of atopic dermatitis and noticed itching sensation followed by erythema within minutes of contact with salmon at the respective contact sites, and subsequent formation of papules. Additionally, the ingestion of salmon resulted in swelling on her lips and throat. She had been working as a cook for 2 years and her sister had suffered from allergy to metal. Patch test with Korean standards and bakery series yielded positive to nickel and cobalt without clinical relevance. In a standardized skin prick test, strongly positive reactions to raw salmon and red snapper were observed after 20 min, but a patch test with the same substances was negative. We report a case of protein contact dermatitis due to salmon and red snapper.