Follicular Traction Urticaria After Patch Test Removal: A Comprehensive Diagnostic Assessment Including Provocation Tests

Abstract

styler/treatment. Products not categorized as conditioners or shampoos on the Target, CVS Pharmacy, and Ulta Beauty websites were included in the "hair styler/treatment" category.Of the 1,960 HCPs (including shampoos, conditioners, styling products/treatments) in the CAMP, 287 (14.6%) were considered "textured HCPs," including 17.3% of conditioners, 15.4% of hair stylers/treatments, and 11.6% of shampoos. Of the 240 HCP brands participating in the CAMP, 55 (22.9%) matched those in the Target, CVS Pharmacy, or Ulta Beauty "textured hair" categories.Fragrance allergy is seen in almost a quarter of patch-tested patients 4 and can be one of the difficult allergens to avoid given its high prevalence in personal care products. 5 Fragrance-free hair products are even more difficult to find. In the CAMP, 5.6% of the HCPs are considered fragrance-free, whereas 29.1% of the moisturizers/lotions are fragrance-free. Of the HCPs for textured hair in the CAMP, we found 0 of 18 conditioners, 3 (7.1%) of 42 shampoos, and 7 (13.7%) of 51 styling products/treatments to be fragrance-free.From this investigation, we concluded that less than 15% of the HCPs within the CAMP are marketed specifically for textured hair, and fragrance-free options are limited. We have included a list of fragrance-free textured HCPs to better enable patients and clinicians to identify safe and appropriate options (Table 1). The lack of fragrance-free textured HCPs commercially available underscores a deficit in the hair care market and illustrates the importance of creating more hypoallergenic HCPs for individuals with textured hair.

Follicular traction urticaria: Is there a delayed onset form?

“…All cases consist of young women developing hives after a short period of time as a result of a traction stimulus. [1][2][3][4][5][6][7] Diagnosis is based on this clinical presentation and the exclusion of other subtypes of chronic inducible urticaria. Differential diagnosis should be performed with follicular dermographism.…”

“…Frick test must be negative in FTU. 1,6,7 However, specific provocation tests have not been stablished yet. 7 We present a 40-year-old woman with a history of resolved aquagenic pruritus over 10 years ago.…”

“…1,6,7 However, specific provocation tests have not been stablished yet. 7 We present a 40-year-old woman with a history of resolved aquagenic pruritus over 10 years ago. There was no personal nor familiar history of atopic dermatitis, atopic comorbidities or chronic spontaneous urticaria.…”

“…Gatica et al proposed a diagnosis approach with different provocation tests. 7 They applied different follicular traction stimuli (patch test, wax and gentle pull of hair) to different locations (back, forearms, legs and axillae). The intensity and the duration of the reaction was associated with the time of stimuli and it was nonexistent on hairless areas.…”

“…Besides, there might be a threshold for hair traction to trigger hives. 7 Differential diagnosis should be made with follicular dermographism. 6,7 It presents as follicle-centered hives in the rubbed area.…”