|LETTER TO EDITOR
|Year : 2000 | Volume
| Issue : 2 | Page : 108
Acute contact urticaria to rice
Rani Radha Mittal, Sonal Jindal
Rani Radha Mittal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mittal RR, Jindal S. Acute contact urticaria to rice. Indian J Dermatol Venereol Leprol 2000;66:108
To the Editor:
Contact urticaria refers to a weal and flare response, which occurs within few minutes to an hour after exposure of intact skin to certain rapidly absorbable agents. Immediate contact urticaria can be immunologically or non-immunologically mediated. In immunologically sensitized individuals, acute contact urticaria results due to contact of skin with protein/protein complexes in the causative agent. Contact urticaria of one month duration, due to rice, was reported in an atopic female.  Immunological contact urticaria to raw rice was reported earlier also. 
One 32-year-old female had suffered from repeated episodes of acute contact urticaria in the form of intense itching, erythema, weals and inflammation of fingers and hands while washing rice, watering from eyes, flushing and erythema of face, weals and sneezing and the patient always needed systemic antihistaminics and topical steroids after each such episode. Later, at times, lesions of hands disappeared and at other times turned into nummular eczema plaques or lichen simplex chronicus (LSC) plaques. Face lesions disappeared within a few hours of medication. No reaction occurred on handling dry rice. She had atopic constitution and had been under our observation since 10 to 12 years either for nummular eczema/LSC hands or urticaria or attacks of drug eruptions due to sulfa/aspirin. She had photosensitivity and suffered from pityriasis simplex and recurrent urticaria during childhood. Her mother also had atopic constitution and her 2 children also suffered from pityriasis simplex and keratosis pilaris. Patch test with dry rice powder/rice powder paste made by dissolving it in water, were applied and the second patch test was positive and patient had to remove the patch within 30-40 minutes due to intense itching.
Contact urticaria to rice is very rare and the present case has been under our observation since 10 years. Her nummular eczema of hands has not recurred since 6 years, since she stopped washing rice. Contact urticaria to rice in an atopic dermatitis patient was explained on the basis of immediate hypersensitivity to soluble proteins in rice.  Both immediate and delayed hypersensitivity were demonstrated by tests in a patient.  Acute contact urticaria to rice can be explained in the present case on the basis of soluble proteins being released and acting as antigen when rice grains are vigorously washed. Lesions of face also occurred probably due to splashing of water droplets containing offending contactant in it. Contact urticaria to rice is so rare that initially I had to believe it only after practical demonstration by the patient.
| References|| |
|1.||Sasai S, Takahashi K, Tagami H. Contact urticaria to rice. Br J Dermatol 1995; 132 : 836-837. [PUBMED] |
|2.||De Lernia V, Albertini G, Bisighini G. Immunological contact urticaria syndrome from raw rice.Contact Dermatitis 1992; 27 : 196. |