Sanmartín Jiménez O, Botella Estrada R, de la Cuadra Oyanguren J, Aliaga Boniche A
Sección de Alergia, Hospital General Universitario, Valencia.
Med Clin (Barc). 1993 Mar 6;100(9):321-4.
Since the recent description of immediate hypersensitivity to latex, many cases have been reported, some of them with anaphylactic reactions. The aim of this study is to analyze the clinical findings, diagnostic management and therapeutic procedures in these patients.
We reviewed the clinical findings in 15 patients with contact urticaria to latex from our files. Use-test with a surgical glove, prick-test trough a rubber glove, RAST to latex and standard patch-tests were performed in each case.
We found a M:F ratio of 1:4 (3 males and 12 females) and the mean age at diagnosis was 33 years. Atopic background was present in 60% of cases and 46% were health care workers. Systemic manifestations of allergy were found in 25% of patients. Two cases developed anaphylactic shock. Cutaneous manifestations included localized contact urticaria in 33% of cases, chronic hand eczema and urticaria in 46%, and immediate contact dermatitis in 20%. All cases showed a positive use-test, while prick-test and RAST showed positive results in only 75% of patients. Positive patch-test to rubber accelerators were found in 33% of cases.
Latex immediate hypersensitivity is frequently seen at present. Its prevalence in health care workers is high. Atopic constitution, chronic hand eczema, continuous gloves usage, and contact dermatitis to rubber additives are predisposing factors. Diagnosis can be assessed by clinical findings and use-test, confirming by prick-test and RAST.
自从最近报道了对乳胶的速发型超敏反应以来，已报告了许多病例，其中一些伴有过敏反应。本研究的目的是分析这些患者的临床发现、诊断管理和治疗程序。
我们回顾了我们档案中15例乳胶接触性荨麻疹患者的临床发现。对每个病例进行手术手套使用试验、通过橡胶手套进行点刺试验、乳胶RAST检测和标准斑贴试验。
我们发现男女比例为1:4（3名男性和12名女性），诊断时的平均年龄为33岁。60%的病例有特应性背景，46%是医护人员。25%的患者有过敏的全身表现。2例发生过敏性休克。皮肤表现包括33%的病例为局限性接触性荨麻疹，46%为慢性手部湿疹和荨麻疹，20%为速发型接触性皮炎。所有病例的使用试验均为阳性，而点刺试验和RAST检测仅在75%的患者中呈阳性。33%的病例斑贴试验对橡胶促进剂呈阳性。
目前乳胶速发型超敏反应很常见。其在医护人员中的患病率很高。特应性体质、慢性手部湿疹、持续使用手套以及对橡胶添加剂的接触性皮炎是易感因素。诊断可通过临床发现和使用试验进行评估，通过点刺试验和RAST检测进行确认。
