Urticarial reaction caused by ethanol.
BACKGROUND
We report a case of an urticarial reaction after drinking alcohol beverages. The patient was a 47-year-old man suffering urticarial and anaphylactoid reaction to alcohol for two years. These reactions were observed at every alcohol beverages intake.


METHODS
We performed a prick test with diluted ethanol, alcohol beverages and their metabolites (acetaldehyde, acetic acid). Only acetic acid showed a positive result. 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.


CONCLUSIONS
Only acetic acid, a metabolite of alcohol, induced a positive prick test in the patient with alcohol-induced urticaria. This result was not observed in normal volunteers. An oral challenge test with diluted-alcohol or Shochu showed a positive wheal reaction in a dose dependent-manner which suggests that urticaria seen in this patient might be induced by alcohol-intolerance. However possible allergic reaction to acetaldehyde could not be excluded.
Nakagawa
Yukinobu
Y
Osaka Kouseinenkin Hospital, Osaka-city, Japan. buntyo@okn.gr.jp
Sumikawa
Yasuyuki
Y
Nakamura
Toshiaki
T
Itami
Satoshi
S
Katayama
Ichiro
I
Aoki
Toshiyuki
T
D000079:Acetaldehyde / Q000009:adverse effects; D019342:Acetic Acid; D000434:Alcoholic Beverages / Q000009:adverse effects*; D000707:Anaphylaxis / Q000139:chemically induced*; D000799:Angioedema / Q000139:chemically induced*; D001515:Beer / Q000009:adverse effects; D004306:Dose-Response Relationship, Immunologic; D000431:Ethanol / Q000009:adverse effects*; D006241:Haptens / Q000009:adverse effects; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018448:Models, Immunological; D009067:Mouthwashes; D010328:Patch Tests; D012882:Skin Tests; D014581:Urticaria / Q000139:chemically induced*; D014920:Wine / Q000009:adverse effects
D006241:Haptens; D009067:Mouthwashes; D007073:Immunoglobulin E; D000431:Ethanol; D000079:Acetaldehyde; D019342:Acetic Acid