Contact urticaria caused by rubber. Analysis of seven cases.

Prior to 1979, there had been no reports of contact urticaria to rubber products. Since that time, many cases have been reported. At New York University, the first case, secondary to cornstarch allergy, was seen in 1985. Since that time, we have seen an additional six cases, five of them in the last year. Of these six cases, three were attributable to H. brasiliensis and three to the accelerators. Although the use of latex products has increased dramatically within the past 9 years in response to the epidemic of human immunodeficiency virus infections, it is not clear whether increased exposure alone accounts for the sudden increase in the number of patients with contact urticaria. Four of the patients presented here are hospital personnel involved in surgical procedures, in which, for decades, latex gloves have been used. Furthermore, two of our seven patients are paraplegics, who, as a group, have long had frequent exposure to rubber products. Two possibilities seem most likely: either the diagnosis has been missed by physicians for decades, or in response to the worldwide demand for latex products, the manufacture of latex has become altered in such a fashion that more products from which the allergens (accelerators and H. brasiliensis) are easily leached are now reaching the marketplace.