Belsito D V
Department of Dermatology, New York University Medical Center, New York.
Dermatol Clin. 1990 Jan;8(1):61-6.
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.
1979年以前，尚无接触橡胶制品引发接触性荨麻疹的报告。自那时起，已有多例相关报告。1985年，纽约大学出现了首例因玉米淀粉过敏继发的病例。从那时起，我们又见到了另外6例，其中5例是在去年。在这6例中，3例归因于巴西橡胶树，3例归因于促进剂。尽管在过去9年里，由于人类免疫缺陷病毒感染的流行，乳胶制品的使用急剧增加，但尚不清楚仅仅是接触增加是否就能解释接触性荨麻疹患者数量的突然增加。这里介绍的4例患者是参与外科手术的医院工作人员，几十年来他们一直在使用乳胶手套。此外，我们的7例患者中有2例是截瘫患者，作为一个群体，他们长期频繁接触橡胶制品。似乎最有可能的两种情况是：要么几十年来医生一直漏诊，要么由于全球对乳胶制品的需求，乳胶的生产方式发生了变化，以至于现在有更多容易浸出过敏原（促进剂和巴西橡胶树）的产品进入市场。
