Cinnamon allergy in a baker

Contact dermatitis in bakers is usually irritant in origin, but there are a large number of potential allergens to which bakers can be exposed. A case is presented of allergic hand dermatitis due to cinnamon.     

Cinnamic aldehyde in toothpaste. 1. Clinical aspects and patch tests

Although cinnamon is known to cause dermatitis in bakers and confectioners, it has only rarely been reported as causing trouble in food or cosmetics. A newly-formulated ‘spicy’ toothpaste containing cinnamon as a flavouring agent was the cause of oral symptoms in eight patients referred to clinics in Buckinghamshire and in Malmo and in a further eight patients discovered Subsequently. Similar symptoms and patch test results were observed independently at both centres. Positive reactions were obtained with 1 % cinnamic aldehyde in 15 out of 16 patients tested. Only one patient reacted to a standard sample of balsam of Peru (25 % in petrolatum).     

Cinnamic aldehyde allergy

Positive patch test reactions to 2% cinnamic aldehyde were obtained from 2.8% of 34 males and 9.1% of 55 females. The 9.1% female reactivity may be traceable to perfumed cosmetics. Simultaneous Jasmin allergy is documented as is the occurrence of alpha-amyl cinnamic aldehyde in synthetic Jasmin. The relevance of these reactions is discussed. In two of the patients a proper diagnosis was not made from the original contact history. Only after a screening tray demonstration of cinnamic aldehyde allergy could a relevant history be taken from these patients.     

Aroma chemicals Reference sources for perfume and flavour ingredients with special reference to cinnamic aldehyde

Bibliographic sources for the complex subject of aroma chemicals are reviewed. The references are not comprehensive but are those which we found to be of value in finding out some of the opportunities for contact with a sensitizing chemical compound, cinnamic aldehyde.     

Sensitivity to cinnamic aldehyde in a toothpaste. 2. Further studies

The authors carried out further studies to assess the significance of the findings of patients sensitive to cinnamic aldehyde in a toothpaste. Selected groups of patients in whom sensitivity to this might have been overlooked were patch-tested. With the exception of three patients, two with cosmetic sensitivity and one with hand eczema, the results were negative. The frequency of use of the original toothpaste was assessed among patients attending the clinic and this was followed by a circular letter to general practitioners and dentists inviting referral of patients with oral symptoms. As a result, five further cases, four of whom gave positive patch test reactions to cinnamic aldehyde, were discovered. The authors emphasize the importance of attempting to obtain accurate information as quickly as possible when 'new' or hitherto unsuspected allergens are implicated.     

Cinnamon dermatitis from an ointment

Six patients are reported who had an allergic contact dermatitis from the use of a proprietary antiseptic ointment containing oil of cinnamon. Three were positive and three negative to balsam of Peru; two of these and one other also reacted to cinnamic aldehyde. The history and usage of cinnamon is briefly reviewed.     

Studies on contact hypersensitivity in the guinea pig The cumulative contact enhancement test

A method to determine the quantitative induction and challenge of the allergenicity of externally applied toiletories and cosmetics, including their components, is described.
The experiment used oil-soluble cinnamic aldehyde and water-soluble formalin as allergens, and guinea pigs as the experimental animals. A high sensitization method resulted, carried out as follows. A 24-h closed patch is attached to the skin every other day over a period of 2 weeks (a total of 4 applications). Freund's complete adjuvant is administered intradermally just before the 3rd application of the patch. The challenge step is performed by directly applying the test material.
This method was compared with other allergenicity evaluation methods. As a result, this method was found to be in no way inferior in sensitization performance to the other methods. The method was used cm perfume mixtures and tested for its evaluation effectiveness. It proved to be satisfactory.     

Contact urticaria from Synthetic cassia oil and sorbic acid limited to the face

A patient with contact urticaria with skin and respiratory symptoms was found to be sensitive to both sorbic acid and synthetic oil of cassia. The contact urticaria was only elicitable on intact skin of the face by open testing. The source of the patient's contactants was her shampoo and toothpaste.     

Acetylsalicylic acid inhibits non-immunologic contact urticaria

Sesame oil has been reported to contain sesamolin, sesamin and sesamol as contact allergens. A female patient had cheilitis due to sesame oil in a lipstick. She reacted to sesamolin and sesamin, but not to sesamol. We carried out analysis of the sesame oil by high performance liquid chromatography. We detected sesamolin and sesamin but not sesamol in sesame oil.     

苦参碱及肉桂酸对体外培养小鼠黑素细胞黑素生成的影响

目的:观察苦参碱和肉桂酸对melan-a小鼠黑素细胞黑素生成的影响。方法:用药物干预melan-a小鼠,观察黑素细胞的形态并测定各组黑素量及酪氨酸酶的活性。结果:肉桂酸干预melan-a小鼠黑素细胞2d后就表现出明显的促进树突生成的作用。肉桂酸和苦参碱在高、中、低浓度(1.00、0.10、0.01mmol/L)有抑制melan-a小鼠黑素细胞酪氨酸酶活性的作用(除外0.01mmol/L苦参碱),其抑制作用均弱于对照药氢醌(P<0.01)。苦参碱(0.001～1.000mmol/L)和肉桂酸(0.001～1.000mmol/L)均能使melan-a小鼠黑素细胞黑素量减少,但其抑制黑素合成的作用明显低于同浓度氢醌。Fontana-Masson染色表明,经苦参碱干预后的melan-a小鼠黑素细胞内黑素颗粒少于空白对照组。结论:苦参碱和肉桂酸均有抑制melan-a小鼠黑素细胞酪氨酸酶活性的作用及使黑素合成量减少的作用,且苦参碱作用强于肉桂酸,而肉桂酸有促进黑素细胞树突形成的作用。     

Simultaneous sensitivity to fragrances

BACKGROUND: Cinnamal/cinnamic alcohol and isoeugenol/eugenol are pairs of related fragrance chemicals found in Fragrance Mix I (FM I), and thus are routinely tested in combination with other fragrances in the European standard patch test series. Their close structural similarity makes the occurrence of simultaneous sensitivity within these chemical pairs likely, although at present there are no robust data to support this hypothesis. OBJECTIVES: To establish the frequency of simultaneous reactions to these fragrance chemicals in patients with suspected fragrance allergy attending a contact dermatitis clinic; to provide evidence in support of proposed metabolic pathways; and to determine whether including all four separately in FM I is necessary to avoid missing a diagnosis of fragrance allergy. METHODS: We analysed retrospectively the records of patients patch tested to the European standard series during the 15-year period 1984-98 for positive reactions to FM I. In a subset of patients tested to the constituents of FM I, positive reactions to cinnamal, cinnamic alcohol, isoeugenol and eugenol were sought. Data were analysed using 2x2 contingency tables (Fisher's exact test). RESULTS: During this period, 23,660 patients were tested to the European standard series, of whom 1811 (7.7%) had positive reactions to FM I. Of the 1112 patients tested to the constituents of FM I, 934 had positive reactions to at least one constituent (total 1324 positive reactions to constituents). Of these 934, 826 also had positive reactions to FM I itself; 108 were negative to FM I but reacted to one or more of its constituents. One hundred and seventy-eight patients did not react to any of the breakdown constituents of FM I; 34 of these had positive reactions to FM I itself. Of 139 patients allergic to cinnamic alcohol, 87 were also allergic to cinnamal (63%), compared with 108 (11.1%) of 973 cinnamic alcohol-negative patients (P<0.00001). Of 231 patients allergic to isoeugenol, 50 were also allergic to eugenol (22%), vs. 109 (12.4%) of 881 isoeugenol-negative patients (P=0.0002). CONCLUSIONS: These data support in vitro experiments indicating that cinnamal and cinnamic alcohol may generate a common hapten and are consistent with the view that simultaneous sensitization to isoeugenol and eugenol occurs to a limited extent, despite their being metabolized via different pathways. In view of the substantial number of isolated reactions to each of these fragrance chemicals, all four should continue to be included separately as constituents of FM I.