Urticarial Wheals Research Articles

PILOMOTOR ACTION OF NICOTINE

If 0.1 to 0.2 cc. of nicotine sulfate or nicotine picrate diluted with physiologic solution of sodium chloride to a concentration of 1: 100,000 is injected intradermally into a human being, during or immediately after the injection goose flesh appears in an irregularly shaped area, 3 to 5 cm. in diameter, surrounding the puncture and subsides within two minutes. The susceptibility to the pilomotor effect of nicotine seems to parallel the tendency of goose flesh to develop physiologically in the subject. The reaction fails to appear if the postganglionic sympathetic fibers of the tested area of skin have degenerated. Furthermore, it fails to appear in certain cutaneous lesions, for instance, in urticarial wheals. Local anesthetics destroy the response even in high dilutions. The test is based on the action of nicotine on sympathetic nerve receptors in the skin. From there the impulse reaches the pilomotor endings by way of an axon reflex. Experiments on the nature of this mechanism will be published in the Proceedings of the Society for Experimental Biology and Medicine , the Journal of Pharmacology and Experimental Therapeutics and the Journal of Investigative Dermatology .

Hypersensitiveness to tobacco and biopsy studies of skin reactions in vascular disease

1. 1. Biopsy studies of immediate and delayed skin reactions to tobacco and saline control wheals were studied in 10 patients with thromboangiitis obliterans, one of migrating phlebitis, and one with acute coronary thrombosis. 2. 2. Eosinophiles, varying in numbers, were found in the histologic sections of the immediate urticarial wheals produced by the tobacco allergen in 6 of 8 cases of thromboangiitis obliterans and in one case of migrating phlebitis. 3. 3. The biopsies of 2 patients with thromboangiitis obliterans and one 37-year-old patient with coronary artery thrombosis, who developed delayed reactions, showed an acute dermatitis. 4. 4. The exciting rôle of tobacco in the 12 cases studied was corroborated clinically by arrest in the progress of symptoms following cessation in the use of tobacco. In one patient (Case 9) giving a delayed eczematous type of local reaction, a generalized eczema and exacerbation of the symptoms of thromboangiitis obliterans were induced by repeated subcutaneous injections of tobacco extract.

URTICARIA DUE TO SENSITIVITY TO COLD

Attention has recently been drawn to the occasional occurrence of sensitivity to such physical agents as heat, cold or pressure. Patients with such sensitivity react to the local stimulus with an urticarial wheal and may in addition show a general constitutional reaction. Duke1in this country has devoted particular attention to this subject. Cases falling in this category have been reported with increasing frequency, especially in the German literature. Investigation of the mechanism of these reactions has yielded many interesting facts, many of them at marked variance with one another, but the etiology has not yet been determined. Many writers have considered the reaction to be allergic or immunopathologic, others, the result of alteration of the colloidal state of the blood and others, the result of altered mechanism of the central nervous system or of peripheral neurovascular mechanisms. Urbach and Fasal,2impressed with the conflicting mass of data

SENSITIZATION PHENOMENA FOLLOWING THE USE OF SODIUM MORRHUATE FOR THE CHEMICAL OBLITERATION OF VARICOSE VEINS

Untoward reaction in the form of a cutaneous eruption or a nitritoid crisis was observed in seven out of 176 patients who received 783 injections of 5 per cent sodium morrhuate (Searle) in the Dermatology Clinic for the chemical obliteration of varicose veins. Two patients received further sodium morrhuate injections without recurrence of the eruption, so the connection is not proved in these two instances. The reactions were : urticarial eruption on the leg, two cases; urticarial eruption on leg and arm, one case; urticaria on arms, one case; pruritus, erythema and edema of arms, one case; pruritic erythematous eruption on leg, one case; weakness for two days, one case. Injections were continued in one patient with urticarial wheals at sites of previous injections, and a nitritoid crisis appeared after six injections, accompanied by cutaneous reaction only. The reaction seen most frequently consisted of grouped urticarial wheals at the sites of previous

URTICARIA

We know that an urticarial wheal can be produced in normal persons by the injection of histamine, morphine and innumerable other substances and also by localized mechanical, thermal or electrical injury. We also know that in patients with serum sickness, hay fever, asthma, and eczema the intradermal injection of the substances to which they are sensitized produces a wheal although these substances have no such effect on normal skin. The serum of allergic subjects will often locally sensitize the skin of normal persons so that it in turn will react to subsequent injection of the allergen or, in some instances, to absorption of the allergen after it is swallowed. The investigations of Philippson, Lewis, Blackley, Prausnitz and Kustner, Walzer and others have established these facts and added greatly to our knowledge of the pathogenesis of wheals. There remains, however, a gap between our understanding of the mechanism of wheal formation

COLD URTICARIA AND HISTAMINE ALLERGY: REPORT OF A CASE

In the last four years, Thomas Lewis and his associates have done much work on the effect of cold on the human skin. They have proved the unusually high histamine content of the normal skin (1: 100,000) and have devised ingenious experiments to show that histamine or a substance like histamine is responsible for the urticarial wheals sometimes produced by cold. In one of these papers1they reviewed the literature and assembled two small groups. In group 1, urticaria was complicated by transient hemoglobinuria, and syphilis was usually present. The first case was reported in 1879. Hemoglobinuria and syphilis were not present in group 2, the first case of which was reported in 1872. Probably wheals from cold have been observed more often than they have been reported. In 1929, Horton and Brown2reported three cases and assembled three more, in which marked systemic histamine-like reactions occurred in

DERMATITIS DUE TO INSECT POWDER

This case is reported on account of certain features that seem of practical importance. <h3>REPORT OF CASE</h3> K. Q., an unmarried woman, aged 33, a housekeeper, noted a disorder of the skin which began on or about May 1, 1929, with several scratchlike marks on the dorsum of the right hand, and rapidly extended to the arms, neck, legs and body. The lesions consisted of vesicular, erythematous and papular eruptions. In some areas the papules and vesicles remained discrete; in others they coalesced to form weeping and denuded areas of varying sizes. Associated with these lesions of eczematous type were also urticarial wheals. The eruption was most severe on the hands, arms and upper parts of the body, and was extremely pruritic. The history and general examination elicited nothing pertinent beyond the following facts: The menses had ceased in April, 1929, with only a slight return of the menstrual flow

The Delayed Type of Allergic Reaction

Article1 January 1930The Delayed Type of Allergic ReactionROBERT A. COOKEROBERT A. COOKESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-3-7-658 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptI thought it might be interesting to present, together with some illustrative cases, a type of hypersensitive reaction in man that has been little appreciated and is not well understood. The usual clinical conditions of asthma and hay fever are, generally speaking, immediate reactions; that is, the attack is precipitated very quickly within from one to thirty minutes after contact with the substance to which sensitiveness exists. In these cases the diagnostic skin test with this substance is also immediately positive, giving the typical urticarial wheal. It is in this group with the immediate clinical + test reactions that the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Presented at the Boston Meeting of the American College of Physicians, April 10, 1929. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFood Sensitivities and Psychological Disturbance: a ReviewCLINICAL SENSITIVITIES TO GELATIN AND OTHER MEAT PRODUCTSThe immunology of allergic diseaseDie klinische Bedeutung des Tuberkulins 1 January 1930Volume 3, Issue 7Page: 658-661KeywordsAllergy and immunologyAsthmaFeversSkin tests ePublished: 1 December 2008 Issue Published: 1 January 1930 PDF downloadLoading ...

SKIN TESTS IN PATIENTS WITH ASTHMA

A cutaneous reaction in a hypersensitive individual was first discovered by Blackley in 1873. This important discovery, neglected by the profession for the next forty years, was revived about fifteen years ago and placed on a firm clinical basis by Cooke, Walker and others. It is based on the fact that those substances which, when inhaled or taken into the body by some other means, are capable of producing asthma will also produce an urticarial wheal when brought into contact with the lower layers of the epidermis. This report covers such tests performed in the Asthma Clinic of the Jefferson Hospital and in private practice for the last six years. All asthma patients coming to the clinic are tested as a matter of routine with about twenty-four different substances. Some new ones were added and some old ones, whose importance was not great, have been dropped from time to time.

THE SKIN-REACTION TO MORPHIN

Solutions of morphin and its esters, when introduced into the skin, produce local reactions, consisting of the urticarial wheal with an erythematous areola (Sollmann and Pilcher 1 ). The lesions are quite like those formed in susceptible individuals by the local inoculation of foreign proteins, and in probably all individuals by inoculation of histamin or any one of a series of definite chemical substances (Sollmann 2 ). This local reaction to the morphins raised a number of interesting questions, some of which will be considered in this paper. Perhaps the most important of these concerns the possibility of the modification of the local reaction by habituation. Does the high degree of tolerance to the toxic actions of the morphins that is acquired by addicts extend also to the local reactions? or, stated conversely, does the local reaction vary with changes in the systemic susceptibility, as is the case with desensitization or habituation to

THE RESULTS IN FOOD ANAPHYLAXIS OBTAINED BY CUTANEOUS AND INTRACUTANEOUS METHODS

Although hypersensibility to foods and its resultant pathologic states has been conjectured for many years, the diagnosis of this idiosyncrasy has not rested on scientific grounds until very recently. In the past, the inference that this or that food substance may in whole or in part be responsible for a diseased state rested on the observation of the patient or the physician or on both, or was made by a process of exclusion. Of recent years, more scientific and accurate methods of diagnosing food hypersensibility have been introduced. The cutaneous method consists in abrading a very small area of the skin with either a needle or a Pirquet borer. Then a small amount of the food protein is rubbed into the abraded surface. A positive reaction is indicated by the development of a well defined urticarial wheal, surrounded by a zone of erythema. This reaction usually appears within from five