BACKGROUND
Positive patch tests to balsam of Peru (BOP) or fragrance mix (FM) suggest the possibility of systemic contact dermatitis from balsam-related foods and spices.
OBJECTIVE
This was a retrospective study to determine whether avoidance of balsam-related foods results in an improvement of dermatitis in these patients.
METHODS
A review of the records of all patients seen from July 1 to Dec 31, 1998 with positive patch tests to BOP, FM, cinnamic aldehyde, and balsam of tolu was performed 9 to 14 months after their evaluation in a tertiary dermatology center. All patients were contacted via telephone to assess the status of their dermatitis and whether they were able to note any specific balsam-related food allergies.
RESULTS
A total of 75 patients were identified, and 71 could be contacted. Fourteen were only allergic to BOP or FM on testing; 31 were positive to BOP/FM and other allergens with presumed relevance to BOP/FM; 26 were positive to BOP/FM and others with other allergens felt to be responsible for the dermatitis and were not placed on a BOP diet. Excluding this last group, 21 of 45 (47%) had complete or significant improvement that they related to dietary modification. Ten did not modify their diet, with 8 reporting no improvement. Eight improved with fragrance or other allergen avoidance only, and 6 modified their diet unsuccessfully. Most commonly implicated foods included tomatoes, citrus, and spices.
CONCLUSION
Almost half of the subjects with positive patch tests to BOP or FM who followed a BOP reduction diet reported significant to complete improvement of their dermatitis.
[1]
J. S. Taylor,et al.
North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens.
,
1998,
Journal of the American Academy of Dermatology.
[2]
T. Hattel,et al.
Can oral challenge with balsam of Peru predict possible benefit from a low-balsam diet?
,
1996,
American journal of contact dermatitis : official journal of the American Contact Dermatitis Society.
[3]
A. Niinimäki.
Double‐blind placebo‐controlled peroral challenges in patients with delayed‐type allergy to balsam of Peru
,
1995,
Contact dermatitis.
[4]
F. Klaschka,et al.
Systemically induced (hematogenous) contact eczema.
,
1990,
Seminars in dermatology.
[5]
T. Hattel,et al.
Reduction of intake of balsams in patients sensitive to balsam of Peru
,
1985,
Contact dermatitis.
[6]
T. Hattel,et al.
Oral challenge with balsam of Peru
,
1985,
Contact dermatitis.
[7]
A. Niinimäki.
Delayed‐type allergy to spices
,
1984,
Contact dermatitis.
[8]
T. Hattel,et al.
Oral challenge with balsam of Peru in patients with eczema: a preliminary study
,
1983,
Contact dermatitis.
[9]
N. Hjorth.
Eczematous allergy to balsams, allied perfumes and flavouring agents, with special reference to balsam of Peru.
,
1961,
Acta dermato-venereologica. Supplementum.
[10]
P. Bonnevie.
Aetiologie und Pathogenese der Ekzemkrankheiten : klinische Studien über die Ursachen der Ekzeme unter besonderer Berücksichtigung des diagnostischen Wertes der Ekzemproben
,
1939
.