Contact allergy to food

Contact allergies to foods, spices, and food additives can occur to individuals in the workplace or at home. Seven different reaction types have been described. These include irritant contact dermatitis, allergic contact dermatitis, contact urticaria, protein contact dermatitis, phototoxic contact dermatitis, photo-allergic contact dermatitis, and systemic contact dermatitis. The causes of each of these are reviewed and an approach to the diagnosis and management of contact allergy to foods, spices, and food additives is formulated.     

Patterns of care and referral in children with atopic dermatitis and concern for food allergy

Although many providers believe that up to 30% of atopic dermatitis (AD) is food induced, food challenge studies show that food-induced eczematous reactions are rare. When food allergy is suggested to cause AD, it often leads to allergy testing with a high false-positivity rate, in turn further focusing parents on food allergy. Study subjects were children less than 11 years old with AD and food allergy suspicion. Prior diagnoses, provider, and testing patterns were assessed by questionnaire given to the parents. Thirty-eight patients with AD were enrolled. Most subject's parents suspected food allergy induced AD. Initial skin diagnoses were made by pediatricians (79%) and family practitioners (18%) as eczema. Allergy was suggested by providers as cause for AD in 63% of the present study's patients. Seventy-nine percent had allergy testing. Greater than 90% of parents claimed their children had food allergy and food-induced AD. Sixty-six percent had positive food allergy tests and 37% had definite history of immediate IgE reactions to food. The majority of this population had allergy suggested as causative for eczema by their primary care provider and were subsequently evaluated by allergist and allergy testing. Consensus about the role of food allergy between the different providers of AD in children would result in more effective, efficient, and less costly health care.     

急性荨麻疹患者食物组过敏原特异性IgE定量检测分析

目的：明确急性荨麻疹患者食入性过敏原特点。方法：对2018年6月至2019年10月我科确诊为急性荨麻疹的患者采用 ELISA 酶联免疫捕获法定量检测食入性过敏原特异性IgE(specific IgE,sIgE),对鸡蛋、牛奶sIgE阳性的部分患者行食物经口负荷实验（oral food challenge,OFC）验证。结果：416例患者中161例sIgE定量检测阳性,其中鸡蛋和牛奶sIgE阳性例数最多,分别为56例和29例。鸡蛋sIgE浓度为0.35～0.70 IU/mL和0.7～2.0 IU/mL患者中OFC阳性率分别为2.8%（1/36）和81.8%（9/11）。牛奶sIgE为0.35～0.70 IU/mL和0.7～2.0 IU/mL患者中OFC阳性率分别为0%（0/16）和37.5%（3/8）。结论：急性荨麻疹患者常见食入性过敏原为鸡蛋、牛奶,患者sIgE浓度<0.7 IU/mL 时可不规避过敏原食物。     

Facial atopic dermatitis is associated with sensitization to cow's milk,egg whites,and peanuts in children under 36 months

Atopic dermatitis (AD) in early childhood often precedes the development of food sensitization and allergy, but the role of treating AD to prevent food allergy remains poorly understood. Our objective was to assess the relationship between facial dermatitis and food sensitization to cow's milk, egg whites, and peanuts in early childhood, as aggressive treatment of facial dermatitis could serve as a potential opportunity for food sensitization prevention. By 3 years of age, food sensitization levels to cow's milk, egg whites, and peanuts were 48% greater in children with facial AD than in children with no facial involvement of their AD. Additional research is needed to determine if facial involvement of AD in infants and young children is associated with increased food allergy.     

Food allergy in patients with eczema: immediate symptoms are usual,with nuts and tomatoes the major allergens

Background Food intolerance is a popular notion in the general population but limited data are available on the presence of food allergy in adult patients with eczema. Objective We wanted to characterize food hypersensitivity in this group of patients. Method A retrospective study was carried out on all patients with food related symptoms attending a cutaneous allergy clinic. Results and conclusion Our study showed that while the reported prevalence of food allergy in adult patients with eczema is low (10%), more than half of these will show immunological evidence of a food allergy which support the clinical history. Immediate symptoms are usual, with nuts and tomatoes the major allergens. Demographic factors such as age, gender and duration of eczema did not significantly correlate with number of foods or an allergen‐specific IgE of ≥ grade 2. Food‐related symptoms were associated with significant anxiety in all our patients leading to a profound effect on their behaviour.     

Aggravation of atopic dermatitis in breast-fed infants by tree nut-related foods and fermented foods in breast milk

Ninety-two exclusively breast-fed Japanese infants with atopic dermatitis were studied to see whether tree nut-related foods (chocolate and coffee) and fermented foods (cheese, yogurt, bread, soy sauce, miso soup and fermented soy beans) eaten by their mothers affected their skin condition. Of the 92 infants, 67 (73%) showed improvement of skin lesions when their mothers avoided these foods and showed aggravation of skin lesions when these foods were reintroduced. The predominant offending foods were chocolate, yogurt, soy sauce and miso soup. A long-term maternal exclusion of the trigger foods brought about progressive improvement of skin lesions in the majority of the infants. These findings suggest that tree nut-related foods and fermented foods are important offending foods of atopic dermatitis in breast-fed infants.     

Allergy is not the main trigger of urticaria in children referred to the emergency room

Background Urticaria is the disease that has the highest impact on quality of life and requires the most visits to the emergency room. Objective To investigate the clinical presentation of acute urticaria in children referred to the paediatric emergency room of our hospital and to define possible related aetiologies. Methods We included 814 children consecutively referred to the emergency room between January 2006 and December 2007 with a diagnosis of acute urticaria, isolated or associated with other clinical symptoms. Results Only 2.0% of the cases studied were associated with severe clinical pictures. In 437 cases (53.7%), the cause of urticaria was not determined. The infections of the respiratory tract were the most frequently suspected aetiological factor. The diagnosis of allergic urticaria is more defined, but belongs to a minority group (10.8%). The first level treatment includes the use of non‐sedating oral H1‐antihistamine. Conclusion The children with urticaria are frequently referred to the paediatric emergency room, but only in a few cases were associated with severe clinical manifestations or allergy. The evidence of an inverse relationship between the number of accesses and the patients' age may be explained by the higher prevalence of this disease in early childhood and possibly also by a higher concern of the parents of the younger patients.     

Oral challenge with food additives

A randomized, placebo-controlled oral challenge with food additives (preservatives and food colorings) was carried out in 101 patients with eczema of undetermined origin who suspected that the intake of certain foods aggravated their dermatitis. 37 reacted to 1 or more of the food additives but not to a placebo, while 16 reacted to the placebo, or both the placebo and food additives. 48 had no reactions. The difference between the number of reactions to the food additives and the number of reactions to the placebo was not statistically significant. The reactions could be reproduced in only 1/3 of those challenged twice. It was not possible to correlate the reactions to food additives to reactivity to specific foodstuffs containing the same additives. If intolerance to food additives is suspected, an elimination diet seems warranted, regardless of whether the patient reacts to oral challenge with food additives.     

New therapeutic vision of nutrition in dermatology: Integrative nutrition

Many skin disorders have been associated with nutritional deficiencies, as well as many skin disorders, have been associated to diet‐related immune mechanisms. The food can be a source of beneficial substances for health that act in very precise ways on the body and the functioning of each individual cells, tissues, and organs.     

Skin testing with food allergens

Skin testing has a central role in the diagnosis of food allergy. Prick testing is well‐ established as a routine diagnostic tool. Nonetheless, unstable allergens and the lack of standardized extracts create difficulties in the identification of sensitization to foods in patients with suspected food allergy. Therefore prick‐to‐prick tests with native (raw, fresh) foods are still recommended. The indications and contraindications are the same as those of routine skin testing in clinical allergology. We recommend a careful and restricted application of skin tests in patients with a history of severe anaphylaxis to foods.     

辛辣食物影响咪唑烷基脲刺激皮肤的动物实验

目的观察辛辣食物对咪唑烷基脲皮肤刺激性的影响,为预防和诊治化妆品皮炎提供科学依据。方法将64只家兔随机分为对照组、酒精组、辣椒组、酒精+辣椒混合组,再将每组家兔进一步分为完整皮肤组和破损皮肤组,分别用0.6%咪唑烷基脲进行单次或多次皮肤刺激实验。并单次刺激皮肤24h及多次刺激皮肤(1次/d)7d后,予肉眼和组织病理评分。结果单次刺激皮肤后,酒精组和混合组破损皮肤出现皮肤刺激反应,该两组与对照组和辣椒组的差异有统计学意义(P均<0.05);多次皮肤刺激后,辣椒组、酒精组和混合组破损皮肤处出现轻、中和重度皮肤刺激反应,该3组与对照组相比,差异有统计学意义(P均<0.05)。各组单次和多次皮肤刺激反应大体和组织病理评分与各组辛辣物质家兔体征的评分之间显著相关(P<0.05)。结论食用辛辣食物会明显增强咪唑烷基脲的皮肤刺激性,且食用辛辣刺激食物越多,对皮肤刺激性越重。     

Allergic contact cheilitis due to geraniol in food

Fragrance materials are present in many foods and are referred to as flavours and spices. However, despite their widespread use, there are few reports of allergic contact dermatitis caused by these additives. Here, we report contact allergy to geraniol in a patient who developed cheilitis on exposure to certain foods.     

Occupational contact urticaria caused by food – a systematic clinical review

Food industry workers are at increased risk for occupational contact urticaria (CU). There are many foodstuffs that have been reported to cause occupational CU, including seafood, meat, vegetables, and fruits. The aim of this review is to summarize all reported occupational cases of CU in the food industry. This is a systematic review based on a MEDLINE search of articles in English and German and a manual search, between 1990 and 2014, to summarize the case reports and case series of occupational CU in the food industry. Many different foodstuffs have been implicated in CU. Occupational CU has been reported in many different occupations, mostly in individuals dealing with seafood, meat, vegetables, and fruits, such as chefs, cooks, bakers, butchers, slaughterhouse workers, and fish‐factory workers. Foodstuffs that commonly induce occupational protein contact dermatitis include fish, seafood, meats, vegetables, and fruits. Food handlers may acquire CU resulting from occupational exposures. The prognosis varies widely. The diagnosis of immunological CU is based on the clinical history and on a positive prick test with the suspected substance and/or measurement of specific IgE.     

Treatment of Chronic Idiopathic Onychodystrophy with Intake of Carotene-rich Food

Background

Onychodystrophy refers to the various abnormalities in nail morphology due to changes in the attachment of the nail plate, changes in nail surface or color. The treatment principle of onychodystrophy largely relies on the discovery and verification of the cause. However, preventive treatment methods offer little help to the patient due to poor compliance, and the effect of corticosteroid is only temporary.

Objective

To evaluate the clinical efficacy of carotene-rich food intake in chronic idiopathic onychodystrophy.

Methods

Ten patients with chronic idiopathic onychodystrophy were recommended to drink one or two cups of carrot juice daily.

Results

Patients showed improvement of onychodystrophy after drinking carrot juice twice a day for at least 4 weeks. No specific adverse effects were noted.

Conclusion

Since there are no reliable treatment methods for chronic idiopathic onychodystrophy, we suggest a simple and compliant treatment method consisting of taking carotene-rich food, such as carrot juice, for patients with chronic idiopathic onychodystrophy.     

过敏性紫癜患者食物特异性免疫球蛋白G抗体检测分析

目的探讨食物特异性免疫球蛋白G(immunoglobulin G,IgG)抗体在过敏性紫癜发病中所起的作用。方法采用酶联免疫吸附法检测55例过敏性紫癜患者血清中的食物特异性IgG抗体,并与48例荨麻疹及30例健康查体人员对照。结果过敏性紫癜组食物特异性IgG抗体阳性29例(阳性率为52.73%),荨麻疹组阳性10例(阳性率为20.83%),健康查体组阳性3例(阳性率为10%),过敏性紫癜组与健康查体组比较差异有统计学意义(P0.001),过敏性紫癜组与荨麻疹组比较差异有统计学意义(P0.001)。食物特异性IgG抗体阳性的过敏性紫癜患者禁食阳性食物后复发率低于未禁食组(P0.05)。结论食物特异性IgG抗体可能在某些过敏性紫癜的发病中起一定作用。     

Nickel in food: The role of stainless-steel utensils

Nickel may be found in prepared foods (tinned foods) at markedly higher concentrations than the safe threshold laid down for hypersensitive patients. Some foodstuffs cooked in stainless-steel utensils attack the metal and thus contain much more nickel than when enamel or aluminum saucepans are used. Among the natural organic acids which may be responsible for dissolving stainless-steel, oxalic acid is the most active at equivalent concentrations.