Disulfite-induced acute intermittent urticaria with vasculitis.
Recognition of sulfite sensitivity by the practicing dermatologist has become increasingly important. A wide spectrum of anaphylactoid reactions can occur after ingestion of sulfite additives in foods and medications. We report the case of a 47-year-old man with severe acute intermittent urticaria. A placebo-controlled oral challenge test with 50 mg sodium disulfite resulted in an acute urticaria attack. A biopsy taken 5 h after the appearance of the urticaria demonstrated a leukocytoclastic vasculitis with eosinophilia. Avoiding foods and drugs containing sulfites is often difficult due to its widespread use. Therefore, the patient should be equipped with a medical emergency kit.
Wüthrich
B
B
Department of Dermatology University Hospital, Zurich, Switzerland.
Kägi
M K
MK
Hafner
J
J
D000799:Angioedema / Q000139:chemically induced; D004417:Dyspnea / Q000139:chemically induced; D004802:Eosinophilia / Q000139:chemically induced; D005503:Food Additives / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010592:Pharmaceutic Aids / Q000009:adverse effects*; D010919:Placebos; D012008:Recurrence; D013447:Sulfites / Q000009:adverse effects*; D014581:Urticaria / Q000139:chemically induced*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced*
D005503:Food Additives; D010592:Pharmaceutic Aids; D010919:Placebos; D013447:Sulfites; C005200:sodium metabisulfite