Another proposed theory is of a water-soluble allergen in the epithelial tissues. Water dissolves the allergen, causing it to diffuse into the tissues, causing histamine release from sensitized mast cells. Diagnosis
Diagnosis of aquagenic urticaria begins with a clinical history and water challenge test. The water challenge test consists of application of a 35°C water compress to the upper body for 30 minutes. Water of any temperature can provoke aquagenic urticaria; however, keeping the compress at a similar temperature to that of the human body (37 °C) avoids confusion with cold urticaria or cholinergic urticaria. In addition, a forearm or hand can be immersed in water of varying temperatures to determine whether temperature is a factor in the patients condition. Aquagenic urticaria differs from aquagenic pruritus, in which contact with water evokes intense itching without visible hives or rash.Once known as a separate, rare disease, aquagenic urticaria is now considered a subtype of general urticaria. The first case was reported by Walter B Shelley et al. in 1964. The condition is more common in women than men, and typically presents for the first time during puberty. Genetics may play a part, and the condition may be related to other sensitivities such as lactose intolerance. Prevention
Desensitization does not seem to work for aquagenic urticaria; a patient will continue to react to water no matter how gradually or frequently it is introduced. Topical application of antihistamines like 1% diphenhydramine before water exposure is reported to reduce the hives.
Bacterial resistance
Bacterial antibiotic resistance is a growing problem in veterinary medicine. Amoxicillin/clavulanic acid is reported to be effective against clinical Klebsiella infections, but is not efficacious against Pseudomonas infections. References
External links
"Amoxicillin / clavulanic acid". Drug Information Portal. U.S. National Library of Medicine.