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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Authors: 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
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:dnet:rdupf_______::d2b029309f9a0549c532705d0bc081c4
Online Access:https://hdl.handle.net/10230/73089
http://dx.doi.org/10.1111/cod.14794
Access Level:Open access
Keyword:Anaphylaxis
Contact urticaria
Inducible urticaria
Occupational urticaria
Protein contact dermatitis
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spelling Contact urticaria and related conditions: clinical reviewBizjak, MojcaAerts, OlivierPesqué, DavidMuñoz, MelbaAsero, RiccardoGonçalo, MargaridaRustemeyer, ThomasKošnik, MitjaKačar, MarkGoossens, AnAlfonso, Jose HernánMortz, Charlotte G.Al-Nesf, Maryam AliFluhr, Joachim W.Maibach, HowardGiménez Arnau, Anna MariaAnaphylaxisContact urticariaInducible urticariaOccupational urticariaProtein contact dermatitisContact 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.Wiley2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/73089http://dx.doi.org/10.1111/cod.14794reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésContact Dermatitis. 2025;93(2):87-107© 2025 The Author(s). Contact Dermatitis published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.)http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:rdupf_______::d2b029309f9a0549c532705d0bc081c42026-06-12T07:21:37Z
dc.title.none.fl_str_mv Contact urticaria and related conditions: clinical review
title Contact urticaria and related conditions: clinical review
spellingShingle Contact urticaria and related conditions: clinical review
Bizjak, Mojca
Anaphylaxis
Contact urticaria
Inducible urticaria
Occupational urticaria
Protein contact dermatitis
title_short Contact urticaria and related conditions: clinical review
title_full Contact urticaria and related conditions: clinical review
title_fullStr Contact urticaria and related conditions: clinical review
title_full_unstemmed Contact urticaria and related conditions: clinical review
title_sort Contact urticaria and related conditions: clinical review
dc.creator.none.fl_str_mv 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
author Bizjak, Mojca
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anaphylaxis
Contact urticaria
Inducible urticaria
Occupational urticaria
Protein contact dermatitis
topic Anaphylaxis
Contact urticaria
Inducible urticaria
Occupational urticaria
Protein contact dermatitis
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/73089
http://dx.doi.org/10.1111/cod.14794
url https://hdl.handle.net/10230/73089
http://dx.doi.org/10.1111/cod.14794
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Contact Dermatitis. 2025;93(2):87-107
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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