Contact urticaria and related conditions: clinical review

Contact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific proteins or chemicals. CoU is categorised into non-immunologic (NI-CoU) and immunologic (I-CoU) types, with I-CoU potentially leading to anaphylaxis. Both forms of CoU can be assoc...

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Detalles Bibliográficos
Autores: Bizjak, Mojca, Aerts, Olivier, Pesqué, David, Muñoz, Melba, Asero, Riccardo, Gonçalo, Margarida, Rustemeyer, Thomas, Košnik, Mitja, Kačar, Mark, Goossens, An, Alfonso, Jose Hernán, Mortz, Charlotte G., Al-Nesf, Maryam Ali, Fluhr, Joachim W., Maibach, Howard, Giménez Arnau, Anna Maria
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:dnet:rdupf_______::d2b029309f9a0549c532705d0bc081c4
Acceso en línea:https://hdl.handle.net/10230/73089
http://dx.doi.org/10.1111/cod.14794
Access Level:acceso abierto
Palabra clave:Anaphylaxis
Contact urticaria
Inducible urticaria
Occupational urticaria
Protein contact dermatitis
Descripción
Sumario:Contact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific proteins or chemicals. CoU is categorised into non-immunologic (NI-CoU) and immunologic (I-CoU) types, with I-CoU potentially leading to anaphylaxis. Both forms of CoU can be associated with protein contact dermatitis and the CoU syndrome. Patients with I-CoU may also have other type I (immediate) allergic diseases, such as allergic conjunctivitis, rhinitis, asthma or food allergy. This review provides a detailed overview of CoU and related conditions, focusing on triggers, diagnostic methods and management strategies. NI-CoU is typically triggered by low molecular weight chemicals, while I-CoU involves IgE-mediated hypersensitivity to both high molecular weight proteins and low molecular weight chemicals. Early diagnosis is crucial, though CoU is often underrecognized. The diagnostic approach includes a thorough medical history, physical examination, evaluation of photographs, (non)invasive skin tests and in vitro assessments. Management strategies prioritise trigger avoidance and pharmacological treatments when avoidance is not fully possible. For I-CoU, second-generation H-antihistamines are the first-line treatment. Severe cases of I-CoU may benefit from anti-IgE therapy (omalizumab). Patients at risk of anaphylaxis should carry an adrenaline auto-injector and wear a medical alert bracelet.