Pharynx gargle samples are suitable for SARS CoV 2 diagnostic use and save personal protective equipment and swabs
tions to balloons, gloves, barium enema, and other latex devices should be taken. The gold standard in the diagnosis is skin prick testing in patients with localized symptoms and latex specific IgE antibody assessment in cases of systemic symptoms.5 However, the wear and/or use test and the patch test are the alternative diagnostic tests.4 The most effective approach for the management of latex allergy is personal and environmental avoidance by considering hypoallergic gloves.4 Recommendations for the prevention of allergic reactions to gloves are summarized in Fig. 1. Urticaria can be treated with antihistamines and the elimination of the antigen. H1,2 Blockers can be used before coming into contact with latex devices; however, latex avoidance is superior to this protocol.4 Plastic gloves, considered as hypoallergenic polyvinylchloride (PVC) gloves, are also used among HCWs. Contact allergic reaction to PVC has also been reported as a result of allergy to many additives used in these gloves, including carba mix, mercaptobenzothiazole (MBT) thiurammix, mixed dialkyl thioureas, and black rubber mix.5 Allergic contact dermatitis has been reported in numerous case reports. Lesions may also become generalized in some patients. A patch test can be used to confirm the diagnosis. Topical corticosteroids are considered as the best choice of treatment; however, patients should be advised to use other types of gloves,5 although allergic contact dermatitis may coexist with immediate hypersensitivity to Latex.5 Nitrile, neoprene, and polyurethane are also used in plastic gloves. Hand dermatitis has been reported with these types of materials. The patch test is recommended in suspicious cases. Application of topical and oral steroids can mitigate the symptoms but the benefits should be weighed against the risks of side effects.6 Glove related hand urticaria should also be considered as a differential diagnosis; it is caused by dermographism upon the application of the glove. Pain, burning, and pruritus in the affected area, and systemic symptoms such as fever are not present in glove related hand urticaria. Further, nitrile gloves are more likely to cause this phenomenon because they are rigid and less flexible.7 Some types of powder used in gloves have been associated with an increased risk of skin roughness due to altering glove pH.8 Glove powder has been reported to cause allergic reactions, and hand eczema has been reported to decrease significantly after using powder free gloves.9 Thus, the use of powder free gloves is recommended in the current pandemic situation. HCWs are also encouraged to wear double gloves when handling COVID 19 patients' airways, blood, urine, and other body fluids. The outer glove should be the first equipment to be removed.2
Infection Control Hospital Epidemiology