L’alcool et la peau (éthylisme) – Table des matières
Dr Christophe Hsu – dermatologist. Geneva, Switzerland
Urticarial and anaphylactoid reactions
- reported to occur minutes after alcohol intake. May occur with anaphylactic symptoms
- reproductible with oral challenge with ethyl alcohol (=ethanol).
- may have genetic intolerance with defects in alcohol-metabolizing enzymes (Oriental flushing syndromes). Many though develop a reaction after red or white wine intake suggesting the preservative, not the alcohol are responsible.
- Differential diagnosis cholinergic urticaria
Alcohol and urticaria: because this phenomenon is incompletely understood, we have selected interesting articles in the scientific literature.
- Nakagawa Y, Sumikawa Y, Nakamura T, Itami S, Katayama I, Aoki T. Urticarial reaction caused by ethanol.Allergol Int. 2006 Dec;55(4):411-4
- Urticarial and anaphylactoid reaction for two years duration observed every time after drinking alcohol beverages in a 47-year-old man.
- Prick tests with diluted ethanol, alcohol beverages and their metabolites (acetaldehyde, acetic acid) were done . Only acetic acid was positive (negative in healthy volunteers).
- Oral challenge test with diluted-ethanol caused pruritus and swelling of his lips. An oral challenge test with 8% diluted Shochu (Japanese distilled alcohol from rice or wheat) caused wheals on his upper back.
- Sticherling M, Brasch J, Brüning H, Christophers E. Urticarial and anaphylactoid reactions following ethanol intake. Br J Dermatol. 1995 Mar;132(3):464-7
- Three patients who presented with recurrent generalized urticaria, which developed within minutes of consumption of small amounts of ethyl alcohol.
- All patients produced positive prick tests with acetic acid, and developed urticaria after oral challenge with small amounts of highly purified ethyl alcohol.
- Ehlers I, Hipler UC, Zuberbier T, Worm M. Ethanol as a cause of hypersensitivity reactions to alcoholic beverages. Clin Exp Allergy. 2002 Aug;32(8):1231-5
- In search of possible pathomechanisms all patients were analysed by skin prick testing.
- The study shows that ethanol itself is a common causative factor in hypersensitivity reactions to alcoholic beverages. These reactions occur dose-dependent and a non-IgE-mediated pathomechanism is likely, because skin prick tests were negative in all cases. Therefore oral provocation tests remain indispensable in making the diagnosis of ethanol hypersensitivity.
Contributors:
Dr Christophe HSU – dermatologist. Geneva, Switzerland
Related posts