Airborne contact dermatitis in a patient with type I and IV sensitivity to chicory

Abstract

Vegetables, including chicory, can be responsible for allergic reactions, most frequently as IgE-mediated immediate reactions (type I) with urticaria. Delayed hypersensitivity reactions (type IV) in terms of allergic contact dermatitis are also possible, notably because of the sesquiterpene lactones present in many vegetables. Moreover, protein contact dermatitis can occur, and is clinically characterized by eczema, positive scratch test results with food protein, and negative patch test results with the same items. Both atopic dermatitis and occupational exposure, for example in bakers, farmers, and cooks, have been described as risk factors for protein contact dermatitis (1). Case ReportA 36-year-old woman with a history of atopic dermatitis presented with cheilitis and eczema on her eyelids, hands, and forearms (Figs 1 and 2). She had previously worked,

Back to the Roots: Revisiting the Use of the Fiber-Rich Cichorium intybus L. Taproots

“…Most of these cases occurred in adults who were in contact with chicory due to their occupation ( 95 – 103 ), and only a single case involved a child reacting to inulin ( 104 ). Allergic reactions to the chicory plant have miscellaneous clinical explanations, being either immediate [IgE-mediated (type 1)] or delayed [T-cell mediated (type 4)], or sometimes both ( 98 , 105 , 106 ). Depending on the individual, allergic symptoms can be systemic and/or local, ranging from rhinoconjunctivitis, to asthma and anaphylactic reactions, to contact dermatitis.…”

“…It is not yet clear exactly how allergic reactions to chicory are triggered. Proteins from chicory or newly formed inulin-protein compounds (arising during production) ( 98 , 108 ), as well as sesquiterpene lactones could be potential allergens ( 105 , 106 ). Sensitization might arise from repeated exposures ( 98 , 106 ) or from cross-sensitization with birch pollen ( 103 , 110 ) or lettuce ( 96 , 101 ).…”

“…Proteins from chicory or newly formed inulin-protein compounds (arising during production) ( 98 , 108 ), as well as sesquiterpene lactones could be potential allergens ( 105 , 106 ). Sensitization might arise from repeated exposures ( 98 , 106 ) or from cross-sensitization with birch pollen ( 103 , 110 ) or lettuce ( 96 , 101 ). Due to all this ambiguity, the general advice is that people with allergies or occupational exposure to Asteraceae family members, people with birch-pollen allergies ( 110 ), and people with atopic dermatitis should be cautious when coming into contact or consuming chicory- and inulin-containing foods ( 106 ).…”