LATEX ALLERGY:

CLINICAL MANIFESTATIONS
ASSESSMENT & DIAGNOSTIC
FINDINGS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
 TYPES OF CAUSE SIGNS/SYMPTOMS TREATMENT
REACTION
Damage to skin because of irritation and loss of epidermoid skin Acute: redness, edema,  Referral for diagnostic testing.
layer; not an allergic reaction. Can be caused by excessive use of burning, discomfort, itching  Avoidance of exposure to irritant.
Irritant contact soaps and cleansers, multiple handwashing, inadequate hand Chronic: dry, thickened,  Thorough washing and drying of hands.
dermatitis drying, mechanical irritation (e.g., sweating, rubbing inside cracked skin  Use of powder-free gloves with more
powdered gloves), exposure to chemicals added during the frequent changes of gloves.
manufacturing of gloves, & alkaline pH of powdered gloves.  Changing glove types.
   Use of water- or silicone-based moisturizing creams, lotions, or topical
Reaction may occur with first exposure, is usually benign, and is not barrier agents.
life threatening.  Avoidance of oil- or petroleum-based skin agents with latex products,
because they cause breakdown of the latex product.

Delayed hypersensitivity (type IV) reaction. Usually affects only area
in contact with latex; reaction is usually to chemical additives used
Allergic contact in the manufacturing process rather than to latex itself. Cause of
dermatitis reaction is T cell–mediated sensitization to additives of latex.
 
Reaction is not life-threatening and is
far more common than a type I reaction. Slow onset; occurs 18–24
h after exposure. Resolves within 3–4 days after exposure. More
severe reactions may occur with subsequent exposures.
Pruritus, erythema, swelling,
crusty thickened skin,
blisters, other skin lesions.
 Referral for diagnosis (patch tests) &
treatment.
 Thorough washing and drying of hands.
 Use of water- or silicone-based moisturizing creams, lotions, or topical
barrier agents.
 Avoidance of oil- or petroleum-based
products unless they are latex compatible.
 Avoidance of identified causative agent, because continued exposure to
latex products in presence of breaks in skin may contribute to latex
protein sensitization.

Type I IgE-mediated immediate hypersensitivity to plant proteins in Rhinitis, flushing,  Immediate treatment of reaction with epinephrine, fluids, vasopressors, &
natural rubber latex. In sensitized people, antilatex IgE antibody conjunctivitis, urticaria, corticosteroids, & airway & ventilator support, w/ close monitoring for
Latex allergy stimulates mast cell proliferation & basophil histamine release. laryngeal edema, recurrence for next 12–14 h.
Exposure can be through contact with the skin, mucous bronchospasm, asthma,  Prompt referral for diagnostic evaluation
membranes, or internal tissues, or through inhalation of traces of severe vasodilation  Treatment and diagnostic evaluation in latex-free environment
powder from latex gloves. angioedema, anaphylaxis,  Assessment of all patients for symptoms of latex allergy
  cardiovascular collapse,  Teaching of patients and family members about the disorder & about the
Severe reactions usually occur shortly after parenteral or mucous death importance of preventing future reactions by avoiding latex (eg, wearing
membrane exposure. People with any type I reaction to latex are at medical alert bracelet, carrying EpiPen)
high risk for anaphylaxis. Local swelling, redness, edema, itching,
and systemic reactions, including anaphylaxis, occur within minutes
after exposure.
 ASSESSMENT & DIAGNOSTIC FINDINGS

Sensitization is detected by skin testing, RAST, ELISA or level of

Hevea latex-specific IgE antibody in the serum.
Skin patch testing is the preferred method for patients with contact
allergies.
TRUE test and other skin tests should be performed only by clinicians
who have expertise in their administration & interpretation & who have
the necessary equipment available to treat local or systemic allergic
reactions to the reagent.
Nasal challenge and dipstick tests may be useful in the future as
screening tests for latex allergy.
 MEDICAL MANAGEMENT

Patients who have experienced an anaphylactic

reaction to latex should be instructed to wear medical
identification.
Antihistamines & an Emergency Kit containing
epinephrine should be provided to these patients
CONT.
Patients should be counseled to notify all health care
workers as well as local paramedic & ambulance companies
about their allergy.
People w/ latex allergy should be provided w/ a list of
alternative products & referred to local support groups
People with type I latex sensitivity may be unable to
continue to work if a latex-free work environment is not
possible.
 NURSING MANAGEMENT

All patients should be asked about latex allergy, although special

attention should be given to those at particularly high risk.

Although the type I reaction is the most significant of the

reactions to latex, care must be taken in the presence of irritant
contact dermatitis and delayed hypersensitivity reaction to avoid
further exposure of the person to latex.
CONT.
Patients with latex allergy are advised to notify their health care
providers and to wear a medical information bracelet.
Patients must become knowledgeable about what products
contain latex and what products are safe, nonlatex alternatives.
They must also become knowledgeable about signs and
symptoms of latex allergy and emergency treatment and self-
injection of epinephrine in case of allergic reaction.