Oral allergy syndrome caused by raw fish in a Japanese sushi bar worker

Oral allergy syndrome (OAS) is a complex of symptoms induced by exposure of the oral and pharyngeal mucosa to food allergens. A 23-year-old female presented in 2006 with oropharyngeal irritation and facial angioedema occurring within 15 min after eating raw fish. Her medical history was significant for mild atopic dermatitis and hand eczema. She had worked in a sushi bar since 2003. Clinical symptoms and positive prick-by-prick test to raw fish confirmed the diagnosis of OAS. It is likely that, our patient was sensitized by direct hand contact with raw fish.     

Contact allergy to cocamidopropyl betaine

Cocamidopropyl betaine is an amphoteric surfactant used increasingly in cosmetic products. We describe 20 cases of cosmetic allergy to cocamidopropyl betaine; all were caused by shampoo or shower gel. 8 patients were hairdressers, who had occupational allergic contact dermatitis from shampoos. We recommend patch testing cocamidopropyl betaine 1%. aq. routinely in hairdressers with dermatitis of the hands, and in all patients suspected of suffering from cosmetic allergy.     

Nickel allergy and atopy in hairdressers

A study of 35 hairdressers with hand eczema was made during an 18-month period. A total of 29 were test-positive to one or more substances in the standard series and/or to products from their working environment. 40% were allergic to nickel. The prevalence of personal atopy was higher in the nickel-negative than in the nickel-positive. Immunoglobulin E determination was not of assistance in attempts to differentiate between nickel-positive and nickel-negative hairdressers. In 72% the eczema had started before the age of 25 and in 23% after less than 1 year in the profession. The desire is expressed that all hairdressing products shall be labelled in respect to allergen contents, since 46% of the hairdressers reacted to one or more such agents.     

Delayed-type allergy to spices

9 common spices were tested epicutaneously in 338 dermatological patients, 118 of whom were allergic to balsam of Peru. Positive reactions to one or more spices were seen in 50 patients all of whom except 2 were allergic to balsam of Peru. The spices giving positive reactions most often were clove, Jamaica pepper and cinnamon (cassia). 2/3 of the patients allergic to balsam of Peru or spices were women, usually suffering from hand eczema. Peroral challenge with spices was carried out in 71 patients allergic to balsam of Peru. Pompholyx on the palms and other objective symptoms were encountered in 7 cases, 3 of whom showed no reactions to spices in epicutaneous tests.     

Occupational contact allergy caused by rubber gloves - nothing has changed

Background. Allergic contact dermatitis caused by rubber gloves is not infrequent, and has almost exclusively been attributed to contact sensitization to accelerators. Thiurams have been the most frequent allergens, followed by dithiocarbamates. Objectives. To describe the current allergen pattern in patients with occupational allergic contact dermatitis caused by rubber gloves. Methods. This study was a retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2002-2010. Results. Of 93 615 patients patch tested in the IVDK, 3448 both suffered from occupational dermatitis and were tested because of suspected glove allergy. Among these, healthcare workers were the largest group (n = 1058). Of all occupational dermatitis patients, 13% were sensitized to thiurams, 3.5% to dithiocarbamates, 3% to mercaptobenzothiazole and/or its derivatives, and 0.4% to thioureas. Positive test reactions to 1,3-diphenylguanidine were seen in 3.0%. Reaction frequencies varied with the years, but showed no uniform time trend. Conclusions. As compared with a former IVDK data analysis (1995-2001), there was no change in sensitization pattern and no decline in sensitization frequencies. This is in line with data from the literature. Particularly in healthcare, there is a need for (i) allergen declaration on the glove package, and (ii) gloves with reduced accelerator content.     

Compound allergy to medicaments

7 patients who reacted on patch testing to medicaments, but who had negative reactions to the individual ingredients are described. The possible mechanisms of this phenomenon are discussed.