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The significance of allergic contact urticaria to milk in children with cow's milk allergy.
Pediatr Allergy Immunol. 2015 May; 26(3):218-222.PA

Abstract

BACKGROUND

Cow's milk allergy (CMA) is the most common food allergy in infancy. Food allergy is generally triggered through ingestion, but can also be triggered through skin contact. We investigated the incidence and the clinical significance of cow's milk protein (CMP)-induced contact urticaria in individuals with CMA with and without atopic dermatitis (AD).

METHODS

A total of 157 children of whom 133 were diagnosed with CMA were participated. The study was based on observational data gathered in the course of patient care, including a skin prick test and a 'finger test', in which cow's milk is applied on the cheek by a physician's finger to detect contact urticaria.

RESULTS

Eighty nine of 133 patients (66.9%) had IgE-mediated CMA. Forty of these 89 (44.9%) tested positive in the finger test. Family atopy was higher in those with positive contact urticaria [21/40 (52.5%) vs. 14/49 (28.5%), p = 0.029]. Patients with positive vs. negative CMP contact urticaria had higher incidence of multiple food allergies [20 of 40 (50%) vs. 7/49 (14.3%), p < 0.004]. IgE-mediated CMA patients with AD had statistically higher CMP allergic contact urticaria compared to patients without AD [71% (15/21) vs. 37% (25/68), p = 0.0064]. Children with non-IgE milk allergy and healthy control group did not have contact urticaria to CMP.

CONCLUSION

CMP contact urticaria exists only in patients with IgE-mediated CMA. A 'finger test' to CMP should be part of the evaluation of CMA patients, and positivity suggests the potential for multiple food allergies, especially to sesame and egg.

Authors+Show Affiliations

Division of Allergy & Clinical Immunology, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.Division of Allergy & Clinical Immunology, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.Pediatric Department, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.Pediatric Gastroenterology Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.Division of Allergy & Clinical Immunology, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

25775957

Citation

Schichter-Konfino, Vered, et al. "The Significance of Allergic Contact Urticaria to Milk in Children With Cow's Milk Allergy." Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, vol. 26, no. 3, 2015, pp. 218-222.
Schichter-Konfino V, Almog M, Bamberger E, et al. The significance of allergic contact urticaria to milk in children with cow's milk allergy. Pediatr Allergy Immunol. 2015;26(3):218-222.
Schichter-Konfino, V., Almog, M., Bamberger, E., Berkowitz, D., & Kessel, A. (2015). The significance of allergic contact urticaria to milk in children with cow's milk allergy. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 26(3), 218-222. https://doi.org/10.1111/pai.12375
Schichter-Konfino V, et al. The Significance of Allergic Contact Urticaria to Milk in Children With Cow's Milk Allergy. Pediatr Allergy Immunol. 2015;26(3):218-222. PubMed PMID: 25775957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The significance of allergic contact urticaria to milk in children with cow's milk allergy. AU - Schichter-Konfino,Vered, AU - Almog,Meital, AU - Bamberger,Ellen, AU - Berkowitz,Drora, AU - Kessel,Aharon, PY - 2015/03/12/accepted PY - 2015/3/18/entrez PY - 2015/3/18/pubmed PY - 2016/1/30/medline KW - atopic dermatitis KW - contact urticaria KW - milk allergy SP - 218 EP - 222 JF - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JO - Pediatr Allergy Immunol VL - 26 IS - 3 N2 - BACKGROUND: Cow's milk allergy (CMA) is the most common food allergy in infancy. Food allergy is generally triggered through ingestion, but can also be triggered through skin contact. We investigated the incidence and the clinical significance of cow's milk protein (CMP)-induced contact urticaria in individuals with CMA with and without atopic dermatitis (AD). METHODS: A total of 157 children of whom 133 were diagnosed with CMA were participated. The study was based on observational data gathered in the course of patient care, including a skin prick test and a 'finger test', in which cow's milk is applied on the cheek by a physician's finger to detect contact urticaria. RESULTS: Eighty nine of 133 patients (66.9%) had IgE-mediated CMA. Forty of these 89 (44.9%) tested positive in the finger test. Family atopy was higher in those with positive contact urticaria [21/40 (52.5%) vs. 14/49 (28.5%), p = 0.029]. Patients with positive vs. negative CMP contact urticaria had higher incidence of multiple food allergies [20 of 40 (50%) vs. 7/49 (14.3%), p < 0.004]. IgE-mediated CMA patients with AD had statistically higher CMP allergic contact urticaria compared to patients without AD [71% (15/21) vs. 37% (25/68), p = 0.0064]. Children with non-IgE milk allergy and healthy control group did not have contact urticaria to CMP. CONCLUSION: CMP contact urticaria exists only in patients with IgE-mediated CMA. A 'finger test' to CMP should be part of the evaluation of CMA patients, and positivity suggests the potential for multiple food allergies, especially to sesame and egg. SN - 1399-3038 UR - https://www.unboundmedicine.com/medline/citation/25775957/The_significance_of_allergic_contact_urticaria_to_milk_in_children_with_cow's_milk_allergy_ L2 - https://doi.org/10.1111/pai.12375 DB - PRIME DP - Unbound Medicine ER -