Immediate contact urticaria to latex gloves
  
  Patient information      Main complaint     Referral     Diagnosis    Results and Treatment   Source
   
Patient information 
A 54 year old woman with
  • a history of reacting to jewellery and sticking plaster
  • redness on her hands after using rubber washing gloves
  • no adverse reactions to local anaesthetics on previous treatments
  • no history of atopy
Main complaint 
The patient experienced itching of her face and rapidly developed a raised erythematous eruption over the left temple and cheek. These symptoms occurred within 30 minutes during dental treatment, and settled down completely within 4 hours. Her dentist had worn disposable latex gloves during her dental examination. 
Referral 
The patient was referred by her dentist to the Dermatology department. 
Diagnosis 
Patch test

Patch tests were performed using the European Standard, preservative, vehicle and emulsifier, fragrance, facial and dental series. The patient demonstrated;

  • irritant reactions to mercury and benzoyl peroxide at the 4 day reading
  • a positive allergic reaction to carba-mix at 4 days

Radioallergosorbent test (RAST)

  • a strong positive reactive to latex

Prick and intra-dermal test

Prick and intra-dermal tests to the local anaesthetic, lignocaine, procaine, prilocaine, bupivacaine and latex were performed. It was found that;

  • a strong positive reaction to latex resulting in a wheal of 12mm diameter at 30 minutes
  • negative reactions to other suspected allergens
Results and Treatment 

Through the diagnosis, it confirmed that this patient had experienced a contact urticarial reaction to latex gloves. This adverse reaction is an immediate (Type I) hypersensitivity reaction.

The patients dentist was advised not to wear latex gloves when treating her. However, she had a further similar reaction after dental treatment by the dentist when no gloves were worn, although he had worn gloves for the treatment of a previous patient. Finally her dentist used PVC gloves when treating her with no adverse reactions.
Source:  

Delayed and immediate orafacial reactions following contact with rubber gloves during dental treatment Shah M, Lewis FM and Gawkrodger DJ.  Br Dent J  1996; 181:137-139.