Contact Urticaria and Protein Contact Dermatitis—a Frequently Hidden Diagnosis

Abstract

We hope that this review can assist in the classification, diagnosis, prevention, and treatment of a contact urticaria syndrome (CUS), a syndrome in which the understanding of such is still evolving. CUS and protein contact dermatitis (PCD) can be defined as an immediate inflammatory reaction of the skin following contact with an external substance. Erythema, wheals, and eczema, as well as other manifestations can occur as a result of this inflammatory reaction. Many low molecular weight substances and proteins are known to produce these immediate skin contact reactions. These reactions affect many occupations such as health care workers, bakers and cooks, and farmers. Nonetheless, as a subset of contact dermatitis, CUS is often misdiagnosed in part due to a lack of understanding and mild severity of its clinical manifestations. A detailed history that elicits environmental and occupational contacts, duration of contacts as well as a detailed understanding of CUS is fundamental to its proper diagnosis.