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Contact Dermatitis Associated With Food: Retrospective Cross-Sectional Analysis of North American Contact Dermatitis Group Data, 2001 – 2004


Abstract and Introduction Abstract Background: Allergic and irritant contact dermatitis to food is likely underreported.

Objectives: To characterize relevant allergens and irritants associated with food in patients referred to the North American Contact Dermatitis Group (NACDG) for patch testing.

Methods: Retrospective analysis of cross-sectional data from the NACDG from 2001 to 2004.

Results: Of 10,061 patch-tested patients, 109 (1.

Approximately two-thirds of patients (66%) were female, and one-third (36%) were atopic.

The hands were the most common sites of dermatitis (36.

There were 78 currently relevant (definite, probable, or possible) allergic reactions to NACDG standard series allergens with a food source; the most common allergen was nickel (48.

Myroxilon pereirae (balsam of Peru) (20.

Twenty allergic reactions to non-NACDG standard allergens and 24 relevant food irritants were also identified.

Overall, 21% (25 of 122) of all reactions (irritant and allergic) were occupation related; the majority of these (17 of 25) were relevant irritant reactions.

Cooks were the most commonly affected occupational group (40%).

Conclusions: In this limited data set, nickel, Myroxilon pereirae, and propylene glycol were the most common allergens identified with a food source.

Of food-related occupational disease, irritation was more common than allergy.

Introduction Although immediate immunologic reactions to food (contact urticaria and respiratory mucosal reactions to food) have been reported,[1,2] dermatitis caused by food exposures is most likely underrecognized and underreported.

It is not uncommon for more than one condition to be present in the same patient, further complicating epidemiologic research.

For example, chronic immunologic contact urticaria and protein contact dermatitis[4] can lead to the clinical appearance of eczematous dermatitis and may coexist with irritant contact dermatitis or allergic contact dermatitis or both.

Most knowledge regarding food-related irritant and allergic contact dermatitis stems from epidemiologic studies of occupational skin disease and case reports and series concerning allergic contact dermatitis.

Bauer and colleagues analyzed 873 bakers, butchers, and cooks suspected of having allergic contact dermatitis who were patch-tested between 1992 and 1999.

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