Background: Contact urticaria (CU) is an underdiagnosed condition representing a significant proportion of allergic skin diseases. Standard patch testing typically cannot detect immediate hypersensitivity reactions characteristic of CU. Despite the need for accurate diagnosis to guide management decisions, specialized immediate-testing protocols required for CU identification lack standardization and are not readily available at most dermatology/allergy centers.Objective: To present a practical CU testing protocol that addresses current diagnostic gaps for immediate-type reactions and can be implemented in dermatology/allergy practices.Methods: We describe our institutional protocol combining short-term occlusive testing with selective skin prick testing for CU diagnosis. The protocol includes patient selection criteria, allergen series and testing materials, step-by-step procedure, safety measures, clinic workflow optimization, and billing considerations.Conclusions: Our CU testing protocol is a method useful for diagnosing immediate hypersensitivity reactions missed by patch testing alone. Incorporating this technique may result in identification of culprit allergens and optimize management through targeted avoidance strategies.
Husmann et al. (Fri,) studied this question.