ALLERGIC REACTIONS FOLLOWING SKIN CONTACT WITH FISH

We evaluated the clinical characteristics Sound in 29 children who sho wed allergic symptoms after direct and/or indirect contact with fish, from 197 children diagnosed with IgE-mediated fish hypersensitivity. A llergic reactions to fish through ingestion began in most patients (79 %) within the first 24 months of rife. All the patients showed cutaneo us symptoms, either alone or associated with other clinical manifestat ions. Whiff and hake were the species more frequently implicated ill e liciting clinical manifestations upon ingestion. After diagnosis, all patients were placed on a strict fish avoidance diet. During this peri od of avoidance, 29 patients reported allergic reactions (mean age 5 y ears, 6 months; SD 4 years, 2 months) after incidental skin contact wi th fish. Clinical manifestations after touching fish were only curtane ous in 28 of the 29 studied patients. One showed local urticaria with wheezing. The majority reported two or more episodes. Incidental skin contact with fish could play an important role in accidental encounter s with fish particles in children on a fish avoidance diet for fish Ig E-mediated hypersensitivity. Such exposures could result in immunologi c immediate contact reactions and in some cases could lend to systemic reactions (contact urticaria syndrome).