Foods To Avoid With Urticaria

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Congenital triangular alopecia Brauer nevus temporally limited alopecia

A granulomatous disease of the bowel. Cutaneous manifestations include pyoderma gangrenosum, exfoliative dermatitis, erythema multiforme and Stevens-Johnson syndrome, urticaria, herpes zoster, palmar erythema, cutaneous Crohn's disease, and necrotizing vasculitis.

Abridged Dictionaryindex

May be associated with urticaria (see ChapJ.2), other illnesses especially B-cell lymphoproliferative disease (AAE-I) or an autoantibody directed against the C1 inhibitor molecule (AAE-II). Angioedema, hereditary. Rare autosomal dominant form of angioedema that may be associated with respiratory and gastrointestinal symptoms. Low level or dysfunctional inhibitor of the first component of complement is the cause.

Allergy And Hypersensitivity

Urticaria results from antigen entering specific skin areas and causing localized anaphylactoid reactions. Histamine released locally causes (1) vasodilation that induces an immediate red flare and (2) increased local permeability of the capillaries that leads to local circumscribed areas of swelling of the skin within another few minutes. The swellings are commonly called hives. Administration of antihista-mine drugs to a person before exposure will prevent the hives.

Clinical Manifestations

The drug, 5-Fluorouracil, as well as high doses of methotrexate, dactinomycin, and doxorubicin, can cause skin eruptions, including urticaria - a generalized erythematous rash. They can also cause hyper-pigmented, brawny, indurated plaques, particularly of the hands and feet, as well as nodularity of the hands and feet 10,17 . These effects are temporary.

Dermatosis caused by arthropods

In this disease, very similar to papular urticaria, the mites invade human skin, but they do not become established in it. There are varieties from dogs, sheep, birds, and so forth. Excoriated, crusted papules can be seen and pruritus can be very severe especially in the evening.

Monoclonal Antibodies That Are Currently Used In Cancer Therapy

Been shown to prolong survival (Dearden, 2002). Treatment-related toxicity, which occurs most often with the first infusion of the antibody, is generally mild. Infusion-related reactions included rigors, nausea, urticaria, fatigue and headache (Dillman, 2002). One advantage of rituximab therapy is that, as it induces minimal adverse effects, it can be given to patients as short-course, outpatient therapy (375 mg m2 weekly for 4-8 weeks).

Vascular Dermatoses

Urticaria Urticaria, erythema multiforme and its variants, and erythema nodosum are included under the heading of vascular dermatoses because of their vascular reaction patterns. Stasis dermatitis is included because it is a dermatosis due to venous insufficiency in the legs.

Dermatitis herpetiformis

Dermatitis herpetiformis is a rare, chronic, markedly pruritic, papular, vesicular, and bullous skin disease of unknown etiology. It is probably an autoimmune disease and activated via the alternate complement pathway. The patient describes the itching of a new blister as a burning itch that disappears when the blister top is scratched off. The severe scratching results in the formation of excoriations and papular hives, which may be the only visible pathology of the disease. Individual lesions heal, leaving an area of hyperpigmentation that is very characteristic. The typical distribution of the blisters or excoriations is on the scalp, sacral area, scapular area, forearms, elbows, and thighs. In severe cases, the resulting bullae may be indistinguishable from pemphigus or bullous pemphigoid.

Rituxan antibody rituximab

Rituxan is jointly marketed by two American companies (IDEC Pharmaceutical and Genentech, California) for short-course outpatient treatment of relapsed or refractory CD20-positive, low-grade or follicular B-cell NHL. Rituxan is a less toxic alternative to chemotherapy and can induce anti-cancer activity by binding to CD20-positive cells, inducing apoptosis, recruiting immune effector functions (i.e. mediating ADCC) and activating complement (Scott, 1998 Hainsworth, 2000). As a single agent, rituximab has been shown to produce a response rate of 50 in patients with relapsed low-grade and follicular NHL. When added to standard chemotherapy in patients with diffuse, large, B-cell NHL, it has also been able to prolong survival in such patients (Dearden, 2002). Treatment-related toxicity, which occurs most often with the first infusion of the antibody, is generally mild. Infusion-related reactions included rigors, nausea, urticaria, fatigue and headache (Dillman, 2002). One advantage of...

Life stages and the skin

In males, at puberty, the beard, the pubic hair, and other body hair begin to grow in characteristic patterns that differ from the hair growth in females. Both sexes at this time notice increased activity of the apocrine glands, with axillary perspiration and body odor and increased development of the sebaceous glands, with the formation of varying degrees of seborrhea and the comedones, papules, and pustules of acne. Certain skin diseases tend to disappear around the onset of puberty, such as the infantile form of atopic eczema, tinea of the scalp, and urticaria pigmentosa.

Polymorphous Light Eruption

The skin lesions, as the name implies, are variable, with papules and vesicles being most common. Plaques, wheals (solar urticaria may be related to PMLE), and petechiae sometimes occur (solar purpura also may be a related condition). Subjective symptoms are less severe than those of protoporphyria. When blisters are prominent, hydroa (aestival vacciniform) is the term often applied ( Fig 30-7).

Allergens in the Workplace

So-called universal precautions resulted in the marked increase in use of latex gloves as personal protective equipment. Since then, the rate of NRL allergy, especially type I allergy, has increased. While approximately 1 of the general population is sensitized to latex, it is now believed that 10-17 of healthcare workers have a type I allergy to NRL allergenic proteins 6, 7 . However, these numbers may be inflated by self-reported allergy assessments. In a study by Allmers 8 , it was found that 63 of healthcare workers self-reporting sensitivity to NRL had negative results (hives, pruritus etc.) when exposed to NRL in an occupational use type of situation.

Helminthic Dermatosis Roundworm

Filariasis is a systemic infection due to one of several different species of nematode, all transmitted by mosquito bites, with hematogenous (rather that cutaneous as in onchocerciasis) spreading of microfilaria. The symptoms are related to chronic inflammation of the lymphatic system. They commonly occur in tropical areas of the world. Loa loa infections are reported in West Africa. Wuchereria bancrofti and Brugia malayi are more common in Asia and tropical Africa. The symptoms are related to the stage of disease. During the hematogenous spread, microfilariae are abundant in blood, producing temporary migratory swelling in extremities that is self-limited and recurrent. Acute lymphangitis and lymphadenitis may affect the groin and axillae. Genital involvement includes acute orchitis, epididymitis, and funiculitis, which are very painful. They can also be recurrent and evolve into fibrosis. Urticaria may be part of the clinical presentation. Late changes are due to...

Spectrum of Occupational Skin Diseases

Diseases relate to the skin (fig. 1) 1 . Occupational skin diseases encompass a wide array of conditions, including acne, cancer, connective tissue disorders, contact dermatitis, infectious diseases, pigment changes, urticaria and aggravation of preexisting skin diseases (table 1). Contact dermatitis is the most frequent and epidemiological relevant occupational skin disease.

Granulomatous slack skin syndrome see Slack Skin syndrome

Viral infection of the liver associated with porphyria cutaneous tarda, lichen planus, essential mixed cryoglobulinemia, Sjogren's syndrome, urticaria, pruritus, membranoproliferative glomerulonephritis, leukocytoclastic vasculitis, and rarely polyarteritis nodosa.

Basic immunology

Table For Basic Immunology

ATOPIC DISEASE AND ATOPIC ECZEMA Atopic conditions include asthma, allergic rhinitis, urticaria, and atopic dermatitis. These conditions are generally associated with elevated serum IgE levels and serum IgE responses to allergens. The role of IgE and exogenous antigens in atopic dermatitis is extremely DRUG ERUPTIONS. Recognition of drugs by the immune system generally requires that the small chemical entities bind to protein and act as a hapten, or directly to MHC molecules. Drug eruptions take many forms, some of which are immune-mediated. Urticarial or anaphylactic reactions can be medicated by IgE degranulation of mast cells. Vasculitic reactions (e.g., palpable purpura) and serum sickness result from deposition of immune complexes and complement in vessels. There is evidence suggesting that morbilliform and bullous (blistering) drug reactions may be mediated by T lymphocytes. URTICARIA. The classic type I or immediate hypersensitivity reaction can cause urticaria and also the...

Fungal infections

Yeast Infection Anticubital Fossa

Histoplasmosis occurs and is caused by direct inoculation. It is a nodular or indurated ulcer with accompanying lymphadenopathy. Occasionally an allergic response has been seen appearing as urticaria or as erythema annulare centrifugum. The diagnosis is accomplished by demonstrating the small intracellular histoplasma in sputum, bone marrow, or biopsy specimens. Treatment is done with ketoconazole or itraconazole.

Eczema

Atopic eczema is a chronic, relapsing pruritic dermatitis that usually occurs in adults and is localized to the flexural surfaces of the face, neck, cubital or popliteal fossa, and hands. The dermatitis usually occurs in patients with a personal or family history of atopy or hay fever asthma urticaria lesions may present as papular, scaly, or chronic lichenified plaques. The cause is unknown but is believed to be IgE mediated. fill

Papules Nodules

Urticaria pigmentosa (Fig 33-21) part of the mastocytosis syndrome, seen as tan brown macules and papules that urticate when stroked (Darier's sign) b. Papular urticaria lesions caused by a delayed hypersensitivity to a variety of arthropod bites present as pruritic erythematous papules with surrounding urticaria. Recurrent crops are seen in the summer and can be quite extensive. c. Erythema multiforme (see Chap 12) an acute hypersensitivity syndrome presenting with macular, urticarial, or vesiculobullous lesions, especially on the

Sauer note

A focus of infection is always considered, sooner or later, in chronic cases of hives, and in unusual instances it is causative. The sinuses, the teeth, the tonsils, the gallbladder, and the genitourinary tract should be checked. Internal disease. Urticaria has been seen with liver disease, intestinal parasites, cancer, rheumatic fever, and others. Nerves. After all other causes of chronic urticaria have been ruled out, there remain a substantial number of cases that appear to be related to nervous stress, worry, or fatigue. These cases benefit most from the establishment of good rapport between the patient and the physician. Contact Urticaria Syndrome. This uncommon response can be incited from the local contact on the skin of drugs and chemicals, foods, insects, animal dander, and plants. Cholinergic Urticaria. Clinically, small papular welts are seen that are caused by heat (hot bath), stress, or strenuous exercise. Differential Diagnosis Dermographism A common finding...

Arachnidism

These mites, also known as harvest mites, are the cause of the infestation known as trombiculiasis. It is seen worldwide, although most frequently in tropical areas. The disease is acquired while walking through vegetation, and the affected area is usually on exposed skin depending on the clothing used. The offending chigger is the larval stage of the mite, 0.25 to 0.4 mm in diameter, orange to red in color, with three pairs of legs. It gets fixed to the skin by its buccal apparatus and starts a process of liquefying and sucking the skin elements. As a consequence it produces a type of papular urticaria multiple red, itchy papules which are extremely pruritic. Topical treatment is with steroids and antipruritic lotions occasionally this condition requires systemic antibiotic and steroid therapy.

Untoward Effects

Moisturizers are in general not qualified to be used under gloves, due to potential inappropriate ingredients, causing penetration enhancement or even sensitization under occlusion. These products, which are intended to elevate the stratum corneum hydration level by their composition, should be restricted for afterwork barrier regeneration. In an experimental study, Held and Jorgensen showed beneficial effects of a moisturizer applied on SLS-impaired skin under glove occlusion. In contrast to the exclusively SLS-impaired and occluded hands in their immersion test, the moisturizer was found to diminish the negative effect on the skin barrier function 20 . However, their results must not be generalized moreover, the concept of using moisturizers under gloves has to be seen very critically for the above-mentioned reasons. The question whether protective creams capable of preventing allergen release from gloves can be created is complex and cannot be answered generally 21-23 . Depending...

Results

At challenge, 75 (64 ) infants showed IgE-mediatedand 43 (36 ) non-IgE-mediated response to CM. Of the IgE-positive infants, 68 reacted within 2 hours compared with 16 in the non-IgE-mediated group. The IgE-positive infants had more often urticaria (76 vs 9 ), but less frequently atopic dermatitis (28 vs 72 ),vomiting (9 vs 30 ),diarrhoea (0 vs 23 ) and wheezing (1 vs 14 ) than those with non-IgE-mediated reaction. During the first 8 weeks at home, the infants with IgE-mediated reaction were exposed to CM less frequently and those who were exposed were given smaller amounts of CM during a shorter period (Table 2). They were breast-fed longer, and greater percentage of them had symptoms suggestive of CMA during exclusive breast-feeding. Of the 50 infants showing symptoms during exclusive breast-feeding, 18 were given CM at hospital. Thus 32 infants were sensitised during exclusive breast-feeding.

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