allergy

New Case of Rare Water Allergy Reported

A new case of aquagenic urticaria (AU), an extremely rare allergic reaction to water exposure, has been reported in a 17-year-old girl in Mapleton, Utah.

AU is a form of physical urticaria characterized by the development of pruritic and occasionally painful hives after contact with water, regardless of its temperature.

“AU was first described by Shelley and Rawnsley1, who reported 3 cases in 1964, and fewer than 100 cases have since been published in the literature,” according to a 2011 case study from the Annals of Dermatology, one of the few case studies on the condition.2
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The 17-year-old girl first experienced a reaction to water exposure 5 years ago, while swimming in a hotel pool while on vacation. The cause of the reaction was originally assumed to be the pool’s chlorine, until a second reaction occurred following exposure to lake water.

Several years later, the teen came across a site describing AU on the Internet, and brought the information to her dermatologist, who confirmed the diagnosis.

“The standard test for AU is application of a 35℃ water compress to the upper body for 30 minutes. Water of any temperature can provoke AU; however, keeping the compress at room temperature avoids confusion with cold-induced or local heat urticaria.”

At this time, the pathogenesis of AU is not well understood. While it most-commonly appears in women around the time of puberty, it can also start later in life or occur in young children, occur alone or in association with other forms of urticaria, and  affect the whole body or just individual portions.

—Michael Potts

References:

  1. Shelley WB, Rawnsley HM. Aquagenic urticaria: contact sensitivity reaction to water. JAMA. 1964;189(12):895-898.
  2. Park H, Kim HS, Yoo DS, et al. Aquagenic urticaria: a report of two cases. Ann Dermatol. 2011;23(3):S371–S374.
  3. ABC News. Utah Teen Diagnosed With Rare Water Allergy. http://abcnews.go.com/Health/utah-teen-diagnosed-rare-water-allergy/story?id=30121194. Accessed April 7, 2015.