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Background: Latex allergy is an important occupational health issue among health care workers (HCWs). Secondary prevention in sensitized/allergic individuals involves avoiding exposure to NRL products. Aims of the study: The aim of this follow-up study is to determine the long-term health consequences in HCWs with type I latex allergy with latex-related contact urticaria syndrome, of providing appropriate information and practical avoidance education. Methods: Seventeen HCWs with latex-induced contact urticaria syndrome, as ascertained by the glove use test, were investigated. Initial and follow-up visits included: a detailed questionnaire, skin prick test (SPT) with glove eluates and with commercial latex extract, SPT with common inhalant and food extracts, serum specific immunoglobulin (Ig)E to latex and some foods and the glove use test. Results: On re-examination, 11 (64.7%) subjects showed positive SPTs to extemporaneous extract and 10 (58.8%) patients showed a positive SPT to commercial extract. Of the nine patients with detectable levels of serum latex specific IgE at first evaluation, four (44.4%) became negative and four were assigned to at least one class lower. Only one (11.1%) employee had higher radioallergosorbent test values than those at the latex allergy diagnosis. At follow-up, the 17 individuals had positive latex challenge results, although the duration of exposure causing a reaction increased. Conclusion: Our study shows that preventive measures are sufficient to induce a reduction of sensitization. Continued avoidance is needed to prevent re-sensitization or adverse reactions on re-exposure.

Background: Natural rubber latex is a frequent cause of IgE-mediated allergy in hairdressers; but a non-IgE-mediated allergy to latex proteins can also occur. Sixty-one hairdressers, reporting latex glove-related symptoms, were enrolled in the study. Methods: They were evaluated for latex allergy by assessment of serum specific IgE and skin prick tests. Patients were patch tested to a rubber additive series and to latex. Proportions were compared by one-tailed Fisher's exact test; mean values of continuous variables were compared by Student's t-test. Results: A diagnosis of IgE-mediated latex allergy was made in 11 (18%) hairdressers; patch tests with rubber-related antigens were positive in 24 (39.3%) subjects. The most positive patch tests were those with para-phenylenediamine (33%). Two hairdressers (3.3%) showed delayed reactions to the latex sample. Hairdressers with IgE-mediated latex allergy were older and presented a personal history of atopy and local hives after exposure to latex; they were more likely to have a positive response to other allergens on prick or patch testing. Conclusions: Our study demonstrates a certain number of false-positive and false-negative results when reported symptoms of possible latex sensitivity were compared to prick and CAP tests to latex, indicating the problems of relying solely on self-report.

Background: Cutaneous adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs), in particular urticaria/angiedema syndrome, represent a frequent problem in clinical practice. To date laboratory tests for the diagnosis of these adverse reactions are not available. A patient with an adverse drug reaction to NSAIDs needs an alternative drug to assume if necessary. Nimesulide is a highly prescribed nonsteroidal anti-inflammatory drug (NSAID) world-wide. It is also described as one of the most tolerated NSAID. In this paper we present data on the tolerability of benzydamine in nimesulide-sensitive patients. Patients and methods: One hundred and thirty-seven patients with nimesulide-induced urticaria were submitted to a single-blind, placebo-controlled peroral challenge with increasing doses of benzydamine. Results: One hundred and thirty-four out of 137 (98%) patients tolerated benzydamine without adverse effects, only three (2%) experienced immediate systemic urticaria (1 at the first dose and 2 at the second dose). Conclusion: Benzydamine is a well tolerated drug in patients with nimesulide-induced urticaria and it may represent a valid alternative NSAID in nimesulide-sensitive patients.

Keywords: allergic contact dermatitis; cutaneous reactions; hydrocortisone sodium succinate; IgE-mediated reactions