Contact Urticaria Syndrome: 1997

Immediate contact reactions (ICRs) are a heterogeneous group of inflammatory responses characterized by development of inflammatory reactions within minutes to few hours after contact with the eliciting substance. Spectrum of reactions varies from sensory responses with itching and/or burning, to localized or generalized urticarial eruptions or even life-threatening extracutaneous effects. ICRs typically occur at site of contact, but can extend beyond, and manifest as contact urticaria (CU), contact urticaria syndrome (CUS) and protein contact dermatitis (PCD). Immunologic and nonimmunologic mechanisms are involved in pathogenesis. Numerous chemicals have been associated with nonimmune- and immune-mediated reactions, while proteinaceous materials are more commonly associated with immune-mediated reactions. Detailed clinical history is the mainstay of diagnosis; skin testing and occasional serologic testing are also useful diagnostic tools. This chapter reviews the classic concepts and presentations of ICRs.