Immediate-Type Testing: Immunologic Contact Urticaria and Immunologic Contact Urticaria Dermatitis
We note a relative paucity of literature on immunologic contact urticaria (ICU) and protein contact dermatitis (now preferentially neologized-immunologic contact urticaria dermatitis). Immunologic contact urticaria differs from nonimmunologic contact urticaria in that the former requires previous exposure to a substance to induce a wheal and flare response on the skin. Contact urticaria can be divided into four clinical stages, ranging from a localized reaction to a systemic, possibly fatal response. To test for ICU, we advise starting with open application testing and moving onto prick testing if negative results ensue. The prick test is a simple, straightforward method used to diagnose ICU and also poses less of a threat for inducing anaphylaxis. In our experience, applying the following tips with prick testing yields less false negatives than with commercial allergens.
KeywordsRelative Paucity Tenfold Dilution Patient Place Codeine Phosphate Contact Urticaria
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