Tea-induced chronic urticaria: A case report and review of the literature

Sir, Urticaria is an immunologically mediated hypersensitivity reaction developing in both sexes. Although it may occur at any age, young females are more frequently affected [1]. Acute urticaria, shorter than six weeks, is generally self-limited. In contrast, a patient with urticaria lasting more than six weeks is classified as having chronic urticaria. Patients with chronic urticaria may be classified into either chronic inducible urticaria or chronic spontaneous urticaria (CSU). Urticaria may be either a true IgE mediated allergic reaction or a non-IgE mediated pseudo-allergic reaction by releasing prostaglandins and leukotrienes [2]. A routine test usually includes CBC, ESR, and infection screening. Provocation tests for physical urticaria and immunological tests are performed to identify autoimmune urticaria. Skin prick tests and oral provocation tests are employed to differentiate allergic and pseudo-allergic reactions [3]. In contrast to physical urticaria, in which the triggering physical stimuli is usually easy to identify, it is often cumbersome to determine the trigger of chronic spontaneous urticaria. The following case represents an example of such a hidden trigger of CSU.