Ethanol-induced urticaria: a case report.
Urticaria, after ingesting ethanol, is rare. A 36-year-old Caucasian male developed multiple, generalized, pruritic urticarial lesions 5 to 15 minutes after drinking alcoholic beverages of any type. A blinded challenge with 5 mL of chemically pure 95% ethanol in concentrated grape juice caused urticaria and an elevation of plasma histamine. Pure grape juice alone was unreactive. Prick skin tests with Brewers' yeast, ethanol, acetaldehyde, and acetic acid were negative. Hydroxyzine (25 mg, p.o., q.i.d.), given for three days prior to challenge, inhibited skin response and histamine release. Biopsy of the urticarial lesions caused by ethanol ingestion showed mast cell degranulation. In this subject, ethanol appeared to directly affect mast cell mediator release by non-IgE mechanisms.
Ting
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Department of Medicine, Allergy and Immunology Service, William Beaumont Army Medical Center, El Paso, Texas.
Rauls
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Ashbaugh
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Mansfield
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D000328:Adult; D003594:Cytoplasmic Granules / Q000648:ultrastructure; D004311:Double-Blind Method; D000431:Ethanol / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D006632:Histamine / Q000097:blood; D006801:Humans; D006919:Hydroxyzine / Q000494:pharmacology; D008297:Male; D008407:Mast Cells / Q000473:pathology / Q000648:ultrastructure; D012867:Skin / Q000473:pathology; D012882:Skin Tests; D014581:Urticaria / Q000097:blood / Q000139:chemically induced* / Q000473:pathology
D006919:Hydroxyzine; D000431:Ethanol; D006632:Histamine