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Colloidal oatmeal exposure and urticaria

Question:

1/18/2018
A pediatric patient was seen in the ER of a local hospital for a non-atopic issue. During his stay, he acutely developed hives. His parents noticed that the nurse caring for him was wearing a pair of nitrile gloves that contained colloidal oatmeal. Do you have any experience with this situation? Should we, as allergists, be making the hospital community aware that these products pose a risk to our oat-allergic patients?

Answer:

Oat allergy is infrequent but it does exist. I do not personally have experience with the situation that you describe. It seems noteworthy that colloidal oatmeal is essentially finely ground oat, which likely increases exposure to the allergenic protein. However, I found a case report of allergic contact urticarial to oatmeal. There are also reports of allergic reactions to personal care products that contain oat. Given the prevalence of food allergens in products which are not made for consumption, it is important to educate our patients about all possible sources of exposure, including contact. So that they may inform health care providers about potential exposures during examinations and procedures. As allergists, we should also be sure to document allergies in our patients' health records, particularly since electronic health records are being increasingly shared among providers. I hope that this response is helpful to you and your patient.

Here is the reference for the case report:
De Paz Aranz S et al. Allergic contact urticarial to oatmeal. Allergy 2002;57(12):1215.

Jacqueline A. Pongracic, MD, FAAAAI