physical allergy

Physical Allergy

Definition

Physical allergies are allergic reactions to cold, sunlight, heat, or minor injury.

Description

The immune system is designed to protect the body from harmful invaders such as germs. Occasionally, it goes awry and attacks harmless or mildly noxious agents, doing more harm than good. This event is termed allergy if the target is from the outside—like pollen or bee venom—and autoimmunity if it is caused by one of the body's own components.

The immune system usually responds only to certain kinds of chemicals, namely proteins. However, non-proteins can trigger the same sort of response, probably by altering a protein to make it look like a target. Physical allergy refers to reactions in which a protein is not the initial inciting agent.

Sometimes it takes a combination of elements to produce an allergic reaction. A classic example is drugs that are capable of sensitizing the skin to sunlight. The result is phototoxicity, which appears as an increased sensitivity to sunlight or as localized skin rashes on sun-exposed areas.

Causes and symptoms

Minor injury, such as scratching, causes itchy welts to develop in about 5% of people. The presence of itchy welts (urticaria) is a condition called dermographism.
Cold can change certain proteins in the blood so that they induce an immune reaction. This may indicate that there are abnormal proteins in the blood from a disease of the bone marrow. The reaction may also involve the lungs and circulation, producing wheezing and fainting.
Heat allergies can be caused by exercise or even strong emotions in sensitive people.
Sunlight, even without drugs, causes immediate urticaria in some people. This may be a symptom of porphyria—a genetic metabolic defect.
Elements like nickel and chromium, although not proteins, commonly cause skin rashes, and iodine allergy causes skin rashes and sores in the mouth in allergic individuals.
Pressure or vibration can also cause urticaria.
Water contact can cause aquagenic urticaria, presumably due to chlorine or some other trace chemical in the water, although distilled water has been known to cause this reaction.

When the inflammatory reaction involves deeper layers of the skin, urticaria becomes angioedema. The skin, especially the lips and eyelids, swells. The tongue, throat, and parts of the digestive tract may also be involved. Angioedema may be due to physical agents. Often the cause remains unknown.

Diagnosis

Visual examination of the symptoms usually diagnoses the reaction. Further skin tests and review of the patient's photosensitivity may reveal a cause.

Treatment

Removing the offending agent is the first step to treatment. If sun is involved, shade and sunscreens are necessary. The reaction can usually be controlled with epinephrine, antihistamines, or cortisone-like drugs. Urticaria may be treated with antihistamines such as diphenhydramine (Benadryl) or desloratadine (Clarinex). Clarinex is non-sedating, meaning it will not make patients drowsy. Itching can be controlled with cold packs or commercial topical agents that contain menthol, camphor, eucalyptus oil, aloe, antihistamines, or cortisone preparations.

Prognosis

If the causative agent has been diagnosed, avoidance of or protection against the allergen cures the allergy. Usually, allergies can be managed through treatment.

Resources

Periodicals

Kirn, F. Timothy. "Desloratadine Improves Urticaria in Clinical Setting." Skin & Allergy News September 2004: 41.

Key terms

Antihistamine — Drugs that block histamine, a major cause of itching.

Hemolysis — Destruction of red blood cells.

Inflammation — Heat, redness, swelling, and pain caused by an immune response.

allergy /al·ler·gy/ (al´er-je) a hypersensitive state acquired through exposure to a particular allergen, reexposure bringing to light an altered capacity to react. See hypersensitivity. aller´gic

atopic allergy atopy.

bacterial allergy specific hypersensitivity to a particular bacterial antigen.

bronchial allergy atopic asthma; see asthma.

cold allergy a condition manifested by local and systemic reactions, mediated by histamine, which is released from mast cells and basophils as a result of exposure to cold.

contact allergy see under dermatitis .

delayed allergy see under hypersensitivity.

drug allergy an allergic reaction occurring as the result of unusual sensitivity to a drug.

food allergy , gastrointestinal allergy allergy produced by ingested antigens in food, usually manifested by a skin reaction.

hereditary allergy atopy.

immediate allergy see under hypersensitivity.

latent allergy that not manifested by symptoms but which may be detected by tests.

physical allergy a condition in which the patient is sensitive to the effects of physical agents, such as heat, cold, light, etc.

pollen allergy hay fever.

polyvalent allergy see pathergy (2).

spontaneous allergy atopy.

physical allergy

Hypersensitivity caused by exposure to various physical factors such as heat, cold, light, or mechanical irritation.

physical allergy,

a hypersensitive reaction to physical factors, such as cold, heat, light, or trauma. Common characteristics include pruritus, urticaria, and angioedema. Usually specific antibodies are found in people having physical allergies. Photosensitivity may be caused by the use of certain cosmetics or drugs. Prophylaxis typically includes an attempt to remove the stimulus, and treatment involves the use of antihistamines or steroids. Compare contact dermatitis. See also atopic dermatitis.

allergy

an altered reactivity following second or subsequent exposure to antigen (allergen). See also hypersensitivity, allergic.

atopic allergy

hereditary predisposition to develop certain allergies. See atopy.

bacterial allergy

a specific hypersensitivity to a particular bacterial antigen, e.g. Mycobacterium tuberculosis; it is dependent on previous infection with the specific organism.

bronchial allergy

asthma.

cold allergy

a condition manifested by local and systemic reactions, mediated by histamine, which is released from mast cells and basophils as a result of exposure to cold.

delayed allergy

see delayed hypersensitivity.

drug allergy

see drug allergy.

drying-off allergy

see milk allergy (below).

food allergy

called also gastrointestinal allergy; see food hypersensitivity.

gastrointestinal allergy

see food allergy (above).

hereditary allergy

an allergy with a hereditary predisposition. The tendency to develop some forms of allergy is inherited, but the specific clinical form is not. IgE, formerly called reagin or reaginic antibody, may be involved. See also atopy.

induced allergy

allergy resulting from the injection of an antigen, contact with an antigen, or infection with a microorganism, as contrasted with hereditary allergy.

inhaled allergy

see atopy.

milk allergy

a hypersensitivity to the milk protein, α-casein. Signs, varying from urticaria to anaphylaxis, have occurred in Jersey cows when milk escapes from the udder into the bloodstream during the drying off period.

physical allergy

a condition in which physical agents, such as heat, cold or light, trigger an allergic response.

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