Reduction of intake of balsams in patients sensitive to balsam of Peru

Abstract

64 patients participated in this study. 24 were patients who had positive patch tests to balsam of Peru. The dermatitis of 9 of the patients had flared after open oral challenge with balsam of Peru, and the dermatitis of 31 patients had flared after double-blind oral challenge. All 64 patients were asked to avoid food items suspected of containing balsams for 1 to 2 months. At the end of that time, an evaluation of the diet trial was made; the dermatitis of 37 had cleared or improved markedly. If an improvement had taken place, the patient was asked to continue to diet moderately. 6 months to 3 years after the diet was initiated, a questionnaire was mailed to those patients whose dermatitis had improved after the first trial. The patients were asked to evaluate the long-term benefit of following the diet. 30 felt there was a long-term effect, and 27 still followed the diet instructions to some degree.

Systemic Contact Dermatitis in Children: How an Avoidance Diet Can Make a Difference

“…Systemic contact dermatitis to BOP can have variable presentations from dermatitis localized to the hands and face to generalized reactions (24). Several studies in adults with SCD to fragrances and BOP have shown that an avoidance diet may benefit about 50% of affected patients (23,25,26). Three of our pediatric cases following dietary avoidance of BOP had significant and sustained clinical improvement.…”

Double‐blind placebo‐controlled peroral challenges in patients with delayed‐type allergy to balsam of Peru

“…The significance of a low-nickel diet for skin symptoms is controversial (19). A diet avoiding food items suspected of containing balsams has been reported to improve dermatitis (2,3). The mildness of the reactions from peroral challenges seen in the present study makes the usefulness of a spice-avoiding diet controversial for patients with chronic hand dermatitis, particularly because the doses of spices used were probably unusually high, although no figures concerning the daily intake of spices or other flavouring agents are available.…”

“…In a previous study (1 ), contact allergy to clove, cinnamon or Jamaica pepper was seen in almost 1 / 2 of the patients with allergy to balsam of Peru, the spices producing flare-ups of pompholyx or reactivation of patch test reactions in 1 / 10 of them when a non-blinded peroral challenge was used. Double-blind placebo-controlled peroral challenges (DBPCPCs) with balsam of Peru produced clinical symptoms in a substantial number of patients with positive patch tests to balsam of Peru, in a study by Veien et al (2), where the symptoms were interpreted by the patients themselves, and a diet without food items suspected to contain balsams was reported to improve dermatitis (2,3).…”

Systemic contact dermatitis

“…Fourteen of 29 who experienced aggravation of their dermatitis after the ingestion of specific food items mentioned spices as a possible cause. Four suggested cinnamon, four curry, and three vanilla 40 . Among Salam and Fowler’s patients, the most commonly implicated foods were tomatoes, citrus, and spices 33 .…”

“…Four suggested cinnamon, four curry, and three vanilla. 40 Among Salam and Fowler's patients, the most commonly implicated foods were tomatoes, citrus, and spices. 33 Niinimäki 41 found reactions to cinnamon and clove among patients with positive patch tests to these two spices.…”