As with many other conditions in allergology, the main component of the treatment of this disease is to limit the use of latex and rubber products. Sometimes, when the reaction is provoked by additional additives, it is enough to change the type of gloves used, condoms, hats or other products. If latex causes allergy, then if it is impossible to completely abandon products made from elastic materials, alternative compounds (for example, polyurethane) are chosen.
Symptomatic treatment of allergies includes the following groups of drugs:
- Antihistamines. Most effective in reagin forms, they suppress the main link in the pathogenesis of the disease – activation of histamine receptors. Often appointed with other types of pathology, in this case, their effectiveness is somewhat reduced. Antihistamines are usually used in the form of tablets that quickly eliminate the symptoms – especially itching and redness.
- Corticosteroid drugs. Corticosteroids are more commonly used topically in the form of ointments and creams. They quickly reduce the activity of inflammation, affecting cellular reactions, therefore, effectively eliminate contact dermatitis.
- Auxiliary means. With a prolonged course of skin forms of latex allergy, the development of dystrophic skin manifestations, which lead to cosmetic disorders, is possible. Their severity is reduced by local and general use of vitamin aids, biogenic stimulants and other drugs.
Latex allergy is considered a fairly common pathological condition, largely due to the widespread use of this material in various fields of human life. Especially many patients are registered among medical staff and workers in the production of rubber products, which is explained by their more frequent and close contact with latex (gloves, patches, some tools). According to statistics, from 5 to 10% of all medical professionals experienced unpleasant symptoms when using rubber materials. In everyday life, genital forms of allergy caused by the use of condoms are more common – they are made from almost pure latex, in addition, the skin and mucous membranes of the genital organs are more permeable to allergens.
Causes of Latex Allergy
The main component of latex or rubber is polymers with a complex structure, but unable to provoke allergic reactions in their pure form. The problem is that the cleaning of the material before its use in the production is imperfect, there remain impurities of various nature, which act as allergens. In the latex of natural origin, these are a variety of vegetable proteins, in synthetic – impurities that fall as a result of the technological process of production. They often lead to negative reactions when using latex objects.
The following conditions are considered to contribute to the development of allergy:
- The presence of allergic diseases. Food allergies to foods such as kiwi, avocados, apples, tomatoes, and nuts are provoking intolerances of latex, especially of natural origin. This is due to the phenomenon of a cross-allergic reaction – the allergens of these products are similar in structure to the antigens of rubber proteins, so the body reacts to them about the same. Due to the altered reactivity of the organism, an increased frequency of latex allergy is observed in individuals with bronchial asthma or eczema.
- Some medical manipulations. Diagnostic and therapeutic procedures that are made with the introduction of latex into the internal environment of the body, increase the risk of developing pathology. These include long-term catheterization of the bladder, some surgical interventions.
- Frequent contact with latex. Prolonged use of latex products in the domestic environment and at work significantly increases the risk of allergies. This situation is common among doctors (gloves and consumables), people working in the manufacture of rubber products and other industries.
- Immunodeficiency. Certain types of reduced immunity (when taking cytotoxic agents, congenital immunodeficiencies) increase the likelihood of allergic diseases in general, including the intolerance of latex materials.
Pathogenesis of latex allergy
The pathogenesis of most types of latex allergy is similar to other variants of the first type intolerance reaction or anaphylaxis. At the first contact of the body with the allergen (proteins or other compounds in the composition of the rubber), a sensitization process occurs with the formation of memory cells “storing” the antigen. An important condition is the penetration of a certain part of the provoking substance into the blood, which is not always possible through the skin.
It is for this reason that this condition is often recorded in individuals who have experienced latex material ingress into the internal cavities of the body – this greatly facilitates sensitization. When repeated contacts with latex, an immunological reaction occurs that is mediated by IgE and leads to degranulation of tissue basophils with the release of histamine and other active compounds.
In other cases, the development of delayed-type reactions is observed, due not to humoral, but to cellular immune responses. When the antigen is repeatedly applied to the surface of the skin, T-lymphocytes (helpers) are activated, which, in turn, leads to the development of T-effectors.
The latter emit biologically active substances, directly attack the tissues in the area of allergen ingress, which leads to the emergence of a clinical picture of chronic contact dermatitis. Such a process takes more time than anaphylaxis, and is practically incapable of provoking systemic reactions – to cause pathological manifestations in parts of the body that have not been in contact with latex.
Latex allergy classification
There are several clinical varieties of latex allergy, differing in their pathogenesis, symptoms and therapies. The classification of this condition also includes pathologies, which, strictly speaking, are not allergies, but are caused by the irritation of tissues by the accompanying chemicals that are part of latex products. These can be powders on gloves, components of lubricant on condoms, paint on items of clothing.
Given this circumstance, the following clinical forms of the disease are distinguished:
- Simple contact dermatitis. Non-allergic version of the pathology caused by irritation of the skin or mucous membranes by chemical compounds. Contact dermatitis is quite easy, manifestations affect only areas of direct contact with the product. To improve the patient’s condition, it is enough to use products based on pure rubber or rubber without auxiliary substances – this proves the absence of an allergy to latex itself.
- Allergic contact dermatitis. It is an allergic condition that develops on the basis of the delayed-type hypersensitivity reaction (DTH). It can be provoked by both rubber itself and auxiliary components of gloves, condoms or other products. Allergic dermatitis is characterized by lesions of the mucous membranes or the skin in the area of contact with latex materials, sometimes with the involvement of neighboring areas.
- Reaction immediate type. Due to the sensitization of the organism and the subsequent reaginic (through IgE) nature of the immunological reaction. The spectrum of manifestations is very wide, depends on the reactivity and the state of the immune system. Possible redness and itching of the skin at the site of contact, as well as systemic reactions.
When diagnosing a condition, it is extremely important to determine its type, since this significantly affects the nature of the treatment measures. Drugs designed to eliminate the immediate type of reaction will be ineffective with HRT or simple dermatitis.
If in some cases it is sufficient to simply change the type of used latex products (of another manufacturer or with a minimum of auxiliary additives), in others it is necessary to completely eliminate contact with this material.
Symptoms of latex allergy
Latex intolerance does not show any specific symptoms, therefore, according to external data alone, a dermatologist or an allergist-immunologist often cannot accurately determine the pathology. Non-allergic contact dermatitis is characterized by redness and dryness of the skin, itching, peeling in the area of contact with rubber materials. This is preceded by long-term use of latex gloves, hats, clothing items – according to statistics, most patients have similar symptoms after a few months or even years of regular and almost daily use of latex. This form of the disease is recorded mainly in physicians.
An allergic variant of contact dermatitis develops faster (from several weeks to 3-4 months of using latex products) and is also characterized by skin manifestations at the site of contact with the provoking substance. Symptoms are more pronounced, itching can flow into a burning sensation, redness of the skin is accompanied by edema.
With continued contact with rubber gloves or other objects, skin manifestations may spread to adjacent areas of skin that are not in contact with latex. Condom use causes itching and redness of the genitals. As a rule, no general symptoms are observed, in severe cases a slight fever, weakness, and headaches are possible.
A reagin form of latex allergy often occurs in individuals with a history of rubber or latex products ingested during therapeutic or diagnostic procedures. Possible causes are long-term use of urethral catheters, the installation of various drains and tubes with the use of rubber components. The result is a sensitization of the body, manifested by allergic reactions in the event of subsequent skin contact with latex. A feature of this form of the disease is the high risk of developing systemic reactions in addition to redness and itching of the skin in the area of contact with the allergen. These include lacrimation, nasal congestion, headaches, cough and shortness of breath.
Complications of latex allergy
The occurrence of angioedema or anaphylactic shock is extremely rare. Anaphylactic shock is manifested by laryngism, a sharp drop in blood pressure, a violation of pulmonary ventilation. Such consequences arise in case of reagin intolerance variants against the background of high body sensitization or immunity disorders.
Other, less pronounced forms of allergy violate the immunological properties of the skin at the site of injury, which, in combination with pruritus and scratching, facilitates secondary infection. Some pathology variants can lead to changes in the mucous membranes (for example, of the genital organs), provoke leukoplakia, erosion, and other disorders.
Diagnosis of latex allergy
Unlike other types of allergies, the diagnosis of latex intolerance is somewhat complicated by non-specific manifestations and a long chronic course. It is very important to compare the data of examination and collection of the patient’s history with the results of laboratory and instrumental methods of research.
With the right approach, it is often enough to establish the fact of frequent contact with latex products to determine the condition; in such cases, other diagnostic procedures are used only to confirm pathology.
The definition of latex allergy includes the following methods:
- Survey and collection history. If intolerance is suspected, they try to identify the possibility and frequency of contact with the material. The patient is ascertained whether he uses rubber products at home or at the workplace (gloves, hats, overalls), whether he uses condoms, whether there have been any surgical interventions in the past. Comparing the data with the clinical picture, the specialist determines the probability of the presence of pathology.
- Allergological studies. These include the skin allergy test method (application or prick test), during which minor amounts of the main antigens of natural and artificial latex are introduced. An indirect sign may be an allergy to some foods – avocados, nuts, tomatoes.
- Laboratory research. In general, and biochemical blood tests noticeable changes are usually absent, with severe leukocytosis and eosinophilia possible. Special studies (to determine the level of specific for latex IgE) reveal the presence of immunoglobulins only in reagin types of pathology.
Differential diagnosis is made with other forms of skin lesions, manifested by redness and itching – urticaria, some forms of dermatitis (for example, atopic).
The main difference is the presence of a stable relationship with the use of latex products, as well as the results of specific allergological and laboratory studies.
Forecast and prevention of latex allergy
The prognosis of latex allergy is almost always favorable, this condition very rarely threatens the life of the patient or leads to serious complications. However, it can create many minor inconveniences, given the wide distribution of material in all areas of life. Persons in contact with latex at work are in a particularly difficult situation – medical staff, workers in the production of latex products.
For the prevention of allergic exacerbations, it is necessary to replace latex objects with other materials (for example, polyurethane), before using rubber gloves, wear others under them, made of thin cotton fabric. Before performing surgical operations, it is extremely important to inform doctors about the presence of such intolerance.