Kanerva L, Pelttari M, Jolanki R, Alanko K, Estlander T, Suhonen R
Section of Dermatology, Finnish Institute of Occupational Health, Helsinki, Finland.
Allergy. 2002 Dec;57(12):1205-7. doi: 10.1034/j.1398-9995.2002.13118.x.
Epoxy resin (ER) is a common cause of occupational allergic contact dermatitis (ACD), but contact urticaria from ER is very rare.
A plastic-product worker first developed ACD from diglycidyl ether of bisphenol A (DGEBA) epoxy resin, and subsequent exposure resulted half a year later in contact urticaria: first with edema of the lips and eyelids, and later an urticarial reaction on the upper chest, with strong swelling of the eyelids and tightness of the throat. The diagnosis was based on a positive skin prick test to his "own" ER compound, a positive prick test reaction to DGEBA, and a positive skin provocation test with the ER compound and DGEBA. The contact urticaria test reaction was strongly aggravated when the allergen was wiped off with an alcohol solution, apparently because the solution enhanced the penetration of the allergen.
Our case is of interest, first, because contact urticaria from ER is very rare, and second, because this is the second report in which a strongly intensified contact urticaria reaction was provoked by an alcohol solution. We suggest that if the contact urticaria provocation test with low-molecular-weight chemicals is negative, a contact urticaria provocation test with alcohol (CUPTA) should be performed.
环氧树脂（ER）是职业性过敏性接触性皮炎（ACD）的常见病因，但由ER引起的接触性荨麻疹非常罕见。
一名塑料制品工人首先因双酚A二缩水甘油醚（DGEBA）环氧树脂患上了ACD，半年后的后续接触导致了接触性荨麻疹：先是嘴唇和眼睑水肿，随后上胸部出现荨麻疹反应，伴有眼睑严重肿胀和喉咙发紧。诊断依据是对其“自身”的ER化合物进行皮肤点刺试验呈阳性、对DGEBA进行点刺试验反应呈阳性，以及对ER化合物和DGEBA进行皮肤激发试验呈阳性。当用酒精溶液擦拭过敏原时，接触性荨麻疹试验反应强烈加重，显然是因为该溶液增强了过敏原的渗透。
我们的病例很有意思，首先是因为由ER引起的接触性荨麻疹非常罕见，其次是因为这是第二例报告中酒精溶液引发强烈加剧的接触性荨麻疹反应。我们建议，如果对低分子量化学物质进行的接触性荨麻疹激发试验为阴性，则应进行酒精接触性荨麻疹激发试验（CUPTA）。
