[Contact urticaria and latex anaphylaxis. A review of 15 cases].
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.