Food-additive-induced urticaria: a survey of 838 patients with recurrent chronic idiopathic urticaria.
BACKGROUND
Recurrent chronic idiopathic urticaria (RCIU) is a common skin condition that affects 0.1-3% of the population in the USA and Europe and accounts for nearly 75% of all 'ordinary' chronic urticaria (CU) cases.


METHODS
We studied 838 consecutive patients with RCIU referred to hospital between 1998 and 2003. Patients with known causes of CU were excluded. Clinical history, physical examination, and symptom diaries were evaluated during two periods, a diet-free period (1 week) and a food-additive-free diet (FAFD) period (4 weeks), respectively, and two double-blind placebo-controlled (DBPC) challenges of six food additives were administered. The first DBPC challenge included a mixture of the six food additives (DBPCmixed) given to all patients. The second DBPC challenge comprised the single food additives, administered at increasing doses (DBPCsingle) to patients with a positive DBPCmixed test and 105 patients with a negative DBPCmixed test, as a control.


RESULTS
The DBPCmixed challenge was positive in 116 patients. None of the 105 control patients had a positive DBPCsingle test. Only 31 DBPCsingle tests were positive in patients with positive DBPCmixed challenge. Twenty-four of the 116 patients showing a positive DBPCmixed challenge also had a positive DBPCsingle result.


CONCLUSIONS
Our results confirmed that food additive hypersensitivity reactions occurred in few RCIU patients using DBPCsingle challenge. The combination of the results of FAFD and DBPCmixed challenge seems to be of considerable practical interest for allergists, internists and dermatologists, rather than the data of clinical history and the results of DBPCsingle challenge, in patients with RCIU.
Di Lorenzo
Gabriele
G
Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo, Palermo, Italia. dilo601@unipa.it
Pacor
Maria Luisa
ML
Mansueto
Pasquale
P
Martinelli
Nicola
N
Esposito-Pellitteri
Maria
M
Lo Bianco
Claudia
C
Ditta
Vito
V
Leto-Barone
Maria Stefania
MS
Napoli
Nicola
N
Di Fede
Gaetana
G
Rini
Giovambattista
G
Corrocher
Roberto
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005503:Food Additives; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D014581:Urticaria / Q000139:chemically induced* / Q000175:diagnosis
D005503:Food Additives