Non-immunological Contact Urticaria (NICU) due to Ethanol Containing Hand Sanitiser: A Case Report

Contact Urticaria (CU) is a wheal and flare reaction, occurring within few minutes to hours of contact to an external agent over skin or mucosa. Depending on underlying pathophysiology, CU is of two types: immunological CU and non-immunological CU. Use of hand sanitisers has increased multifold in this COVID-19 pandemic, due to increased awareness regarding maintaining a good hygiene to reduce the transmission of infection. This present case is a 24-year-old man, who overzealously added ethanol-based hand sanitiser to his bathing water on the advice of a general physician and after bathing developed redness, swelling and itching on various body parts. A diagnosis of Non-immunological CU (NICU) due to ethanol in sanitiser was made, based on history and clinical examination.

Diagnostic value of autologous serum skin test in chronic auto immune urticaria

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Urticaria affects up to 20% of the population during their life time. Urticaria occurring on almost all days for more than 6 weeks is classified as chronic urticaria. Chronic urticaria is one of the most vexing management problems the dermatologists face. Chronic urticaria cases in which no etiology can be found are labelled chronic idiopathic urticarial (CIU). In most cases of idiopathic urticaria, autoimmunity may be the initiating factor- chronic autoimmune urticaria. Autologous serum skin test (ASST) is a simple and reliable method to detect autoimmune urticaria.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Among patients with chronic idiopathic urticaria, ASST is done to detect ASST positivity and thereby chronic autoimmune urticaria. Patient’s serum is separated and 0.05 ml injected intradermally on left forearm. Normal saline is injected intradermally at least 5 cm away as control. Wheal and flare at serum site which is 1.5 mm more than that of control is taken as positive. Results were analyzed using Microsoft excel and Epi info7</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">49 patients were studied and 34 (69.4%) showed ASST positivity, which is an indicator of autoimmune urticaria. Moreover, it was seen that ASST positive patients had more episodes of urticaria per week, compared to ASST negative patients. </span></p><p class="abstract"><strong>Conclusions:</strong> ASST is a simple and reliable method to detect chronic autoimmune urticaria. <span lang="EN-IN">ASST positive patients have more episodes of urticaria compared to ASST negative patients.</span></p>

Allergic Diseases

Standard allergy testing relies on identifying the immunoglobulin (Ig) E antibody specific for the allergen in question. Two classic methods of doing this are the immediate wheal-and-flare skin prick tests (in which a small amount of antigen is introduced into the skin and the site is evaluated after 15 minutes for the presence of an immediate wheal-and-flare reaction) and in vitro (blood) testing. Methods of allergy testing that do not have a clear scientific basis include cytotoxic testing, provocation-neutralization testing or treatment, and “yeast allergy” testing.