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urticarial reaction

What is responsible for this urticarial reaction?

DAVID L. KAPLAN, MD—Series Editor University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Volume 52 - Issue 7 - July 2012

urticarial reaction

A 63-year-old woman believes that her hives of 1 day’s duration were brought on by something she ate.

Which specific food(s) do you query the patient about?

A. Alcohol.

B. Tomatoes.

C. Shellfish.

D. Nuts.

E. Chocolate.

F. Strawberries.

Answer: Urticarial reaction

All of the choices could have triggered the urticarial reaction; questioning revealed that this patient’s hives were precipitated by eating shrimp, C. This was confirmed 1 month later when she was rechallenged by inadvertently eating a shrimp dip. Both the initial and subsequent reactions cleared following a course of antihistamines. The patient was advised to avoid eating shellfish in the future.