Wakelin S H
Department of Dermatology, St Mary's Hospital, London, UK.
Clin Exp Dermatol. 2001 Mar;26(2):132-6. doi: 10.1046/j.1365-2230.2001.00780.x.
Contact urticaria has been reported following skin contact with a multitude of substances ranging from simple chemicals to macromolecules. Its prevalence amongst the general population is unknown, but it may be a relatively common and under-recognized phenomenon. Non-immunological (irritant) causes typically elicit mild localized reactions, which clear within hours. Such agents can be found widely in food, cosmetics and medicaments. The lower diagnostic end-point for nonimmunological contact urticaria has been the subject of debate, which makes interpretation of the literature difficult. Immunological (allergic) contact urticaria is due to immediate-type hypersensitivity, and occurs most commonly in atopic individuals. It is mediated primarily by histamine, and may be associated with systemic, and potentially life-threatening symptoms. Natural rubber latex is one of the most important causes today, and the recent 'epidemic' of latex protein allergy has helped draw attention to this subject. Immunological contact urticaria to animal or vegetable matter may occasionally affect those who handle food, and other occupations such as agricultural and veterinary workers. This may be associated with development of a protein contact dermatitis. The diagnosis of immunological contact urticaria can often be confirmed by simple investigations such as skin prick testing or measurement of specific IgE.
据报道，皮肤接触从简单化学物质到大分子等多种物质后会发生接触性荨麻疹。其在普通人群中的患病率尚不清楚，但可能是一种相对常见且未被充分认识的现象。非免疫性（刺激性）原因通常引起轻度局部反应，数小时内消退。这类物质在食品、化妆品和药物中广泛存在。非免疫性接触性荨麻疹的较低诊断终点一直存在争议，这使得对文献的解读变得困难。免疫性（过敏性）接触性荨麻疹是由速发型超敏反应引起的，最常见于特应性个体。它主要由组胺介导，可能伴有全身性且潜在危及生命的症状。天然橡胶乳胶是当今最重要的病因之一，最近乳胶蛋白过敏的“流行”有助于引起人们对这一问题的关注。对动物或植物物质的免疫性接触性荨麻疹偶尔会影响从事食品处理工作的人员以及其他职业，如农业和兽医工作者。这可能与蛋白质接触性皮炎的发生有关。免疫性接触性荨麻疹的诊断通常可以通过简单的检查来证实，如皮肤点刺试验或特异性IgE检测。
