Contact Urticaria and Related Conditions: Clinical Review

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Main Authors: Mojca Bizjak, Olivier Aerts, David Pesqué, Melba Muñoz, Riccardo Asero, Margarida Gonçalo, Thomas Rustemeyer, Mitja Košnik, Mark Kačar, An Goossens, Jose Hernán Alfonso, Charlotte G. Mortz, Maryam Ali Al‐Nesf, Joachim W. Fluhr, Howard I. Maibach, Ana Maria Giménez‐Arnau
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Published: Wiley 2025
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author Mojca Bizjak
Olivier Aerts
David Pesqué
Melba Muñoz
Riccardo Asero
Margarida Gonçalo
Thomas Rustemeyer
Mitja Košnik
Mark Kačar
An Goossens
Jose Hernán Alfonso
Charlotte G. Mortz
Maryam Ali Al‐Nesf
Joachim W. Fluhr
Howard I. Maibach
Ana Maria Giménez‐Arnau
author_facet Mojca Bizjak
Olivier Aerts
David Pesqué
Melba Muñoz
Riccardo Asero
Margarida Gonçalo
Thomas Rustemeyer
Mitja Košnik
Mark Kačar
An Goossens
Jose Hernán Alfonso
Charlotte G. Mortz
Maryam Ali Al‐Nesf
Joachim W. Fluhr
Howard I. Maibach
Ana Maria Giménez‐Arnau
Mojca Bizjak
Olivier Aerts
David Pesqué
Melba Muñoz
Riccardo Asero
Margarida Gonçalo
Thomas Rustemeyer
Mitja Košnik
Mark Kačar
An Goossens
Jose Hernán Alfonso
Charlotte G. Mortz
Maryam Ali Al‐Nesf
Joachim W. Fluhr
Howard I. Maibach
Ana Maria Giménez‐Arnau
collection Wiley Open Access
contents Contact Urticaria and Related Conditions: Clinical Review Mojca Bizjak Olivier Aerts David Pesqué Melba Muñoz Riccardo Asero Margarida Gonçalo Thomas Rustemeyer Mitja Košnik Mark Kačar An Goossens Jose Hernán Alfonso Charlotte G. Mortz Maryam Ali Al‐Nesf Joachim W. Fluhr Howard I. Maibach Ana Maria Giménez‐Arnau Contact Dermatitis ABSTRACTContact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific proteins or chemicals. CoU is categorised into non‐immunologic (NI‐CoU) and immunologic (I‐CoU) types, with I‐CoU potentially leading to anaphylaxis. Both forms of CoU can be associated with protein contact dermatitis and the CoU syndrome. Patients with I‐CoU may also have other type I (immediate) allergic diseases, such as allergic conjunctivitis, rhinitis, asthma or food allergy. This review provides a detailed overview of CoU and related conditions, focusing on triggers, diagnostic methods and management strategies. NI‐CoU is typically triggered by low molecular weight chemicals, while I‐CoU involves IgE‐mediated hypersensitivity to both high molecular weight proteins and low molecular weight chemicals. Early diagnosis is crucial, though CoU is often underrecognized. The diagnostic approach includes a thorough medical history, physical examination, evaluation of photographs, (non)invasive skin tests and in vitro assessments. Management strategies prioritise trigger avoidance and pharmacological treatments when avoidance is not fully possible. For I‐CoU, second‐generation H1‐antihistamines are the first‐line treatment. Severe cases of I‐CoU may benefit from anti‐IgE therapy (omalizumab). Patients at risk of anaphylaxis should carry an adrenaline auto‐injector and wear a medical alert bracelet. 10.1111/cod.14794 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/cod.14794
format Artículo Open Access
id wiley_oa_10_1111_cod_14794
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2025
publisher Wiley
record_format wiley_oa
spellingShingle Contact Urticaria and Related Conditions: Clinical Review
Mojca Bizjak
Olivier Aerts
David Pesqué
Melba Muñoz
Riccardo Asero
Margarida Gonçalo
Thomas Rustemeyer
Mitja Košnik
Mark Kačar
An Goossens
Jose Hernán Alfonso
Charlotte G. Mortz
Maryam Ali Al‐Nesf
Joachim W. Fluhr
Howard I. Maibach
Ana Maria Giménez‐Arnau
Contact Dermatitis
Contact Urticaria and Related Conditions: Clinical Review Mojca Bizjak Olivier Aerts David Pesqué Melba Muñoz Riccardo Asero Margarida Gonçalo Thomas Rustemeyer Mitja Košnik Mark Kačar An Goossens Jose Hernán Alfonso Charlotte G. Mortz Maryam Ali Al‐Nesf Joachim W. Fluhr Howard I. Maibach Ana Maria Giménez‐Arnau Contact Dermatitis ABSTRACTContact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific proteins or chemicals. CoU is categorised into non‐immunologic (NI‐CoU) and immunologic (I‐CoU) types, with I‐CoU potentially leading to anaphylaxis. Both forms of CoU can be associated with protein contact dermatitis and the CoU syndrome. Patients with I‐CoU may also have other type I (immediate) allergic diseases, such as allergic conjunctivitis, rhinitis, asthma or food allergy. This review provides a detailed overview of CoU and related conditions, focusing on triggers, diagnostic methods and management strategies. NI‐CoU is typically triggered by low molecular weight chemicals, while I‐CoU involves IgE‐mediated hypersensitivity to both high molecular weight proteins and low molecular weight chemicals. Early diagnosis is crucial, though CoU is often underrecognized. The diagnostic approach includes a thorough medical history, physical examination, evaluation of photographs, (non)invasive skin tests and in vitro assessments. Management strategies prioritise trigger avoidance and pharmacological treatments when avoidance is not fully possible. For I‐CoU, second‐generation H1‐antihistamines are the first‐line treatment. Severe cases of I‐CoU may benefit from anti‐IgE therapy (omalizumab). Patients at risk of anaphylaxis should carry an adrenaline auto‐injector and wear a medical alert bracelet. 10.1111/cod.14794 http://creativecommons.org/licenses/by/4.0/
title Contact Urticaria and Related Conditions: Clinical Review
topic Contact Dermatitis
url https://onlinelibrary.wiley.com/doi/10.1111/cod.14794