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Contact urticaria in Adult
See also in: Cellulitis DDx
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Contact urticaria in Adult

See also in: Cellulitis DDx
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Contributors: Tara Mahar MD, Art Papier MD
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Synopsis

Contact urticaria may be immunologic (allergic) or non-immunologic (non-allergic). The immunologic form is an immediate hypersensitivity reaction (IgE-mediated) that occurs when the skin is directly exposed to an allergen. It may rarely be complicated by anaphylaxis and is more common in atopic individuals. Substances that have been found to cause this reaction include latex, foods (meat, raw potato, and fish), preservatives, disinfectants, fragrances, formaldehyde, epoxy resin hardeners, several woods, and therapeutic drugs. Non-immunologic contact urticaria often occurs without previous sensitization and usually remains localized. Substances that cause non-immunologic contact urticaria include benzoic acid, sorbic acid, cinnamic acid, cinnamic aldehyde, nicotinic acid esters, insects, nettles and other plants, foodstuffs (fish, mustard, cayenne pepper, thyme), as well as materials related to the medical industry (alcohol, benzocaine, tincture of benzoin, witch hazel, balsam of Peru, DMSO).

In both of these forms, contact with the inciting agent triggers an inflammatory reaction in which capillary permeability changes. Fluid leaks into the area of contact, causing a wheal and flare reaction. These wheals (hives) are raised areas of the skin that are pink or red in color and often intensely pruritic. Individual wheals, once formed, are self-limiting and will subside when exposure to the causative substance has ceased. Prevention of this condition by avoiding known causative agents is the best treatment.

Contact urticaria can be differentiated from cellulitis based on time course and exposure history. Contact urticaria develops and resolves quite quickly, whereas cellulitis, by comparison, is a more indolent and progressive process.

Codes

ICD10CM:
L50.6 – Contact urticaria

SNOMEDCT:
19364004 – Contact urticaria

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Other forms and causes of urticaria include the following:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 07/18/2017
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Contact urticaria in Adult
See also in: Cellulitis DDx
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Contact urticaria : Burning skin sensation, Erythema, Hives
Clinical image of Contact urticaria
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