title: alpha-Amylase, a flour additive: an important cause of protein contact dermatitis in bakers.
abstract: BACKGROUND
  alpha-Amylase, an enzyme commonly used in flour additives, has been reported to be an important cause of rhinitis and asthma in bakers.
  
  
  OBJECTIVE
  Our purpose was to determine whether this enzyme could also cause dermatitis. We tested it routinely in bakers with hand eczema.
  
  
  METHODS
  Patch tests were administered with the International Contact Dermatitis Research Group standard series and a bakery series and scratch-chamber or prick tests were performed with the bakers' own material and with alpha-amylase powder.
  
  
  RESULTS
  Of 32 bakers tested, seven had an immediate wheal-and-flare reaction and two also had a delayed eczematous reaction. High dilutions of the alpha-amylase powder still gave strong reactions.
  
  
  CONCLUSIONS
  alpha-Amylase is an important cause of skin reactions in bakers and should be tested routinely if a contact allergy is suspected.
authors.affiliation: Department of Dermatology, University Hospital, Katholieke Universiteit Leuven, Belgium.
authors.forename: M A
authors.initials: MA
authors.lastname: Morren
authors.forename: V
authors.initials: V
authors.lastname: Janssens
authors.forename: A
authors.initials: A
authors.lastname: Dooms-Gossens
authors.forename: E
authors.initials: E
authors.lastname: Van Hoeyveld
authors.forename: A
authors.initials: A
authors.lastname: Cornelis
authors.forename: C
authors.initials: C
authors.lastname: De Wolf-Peeters
authors.forename: A
authors.initials: A
authors.lastname: Heremans
mesh_terms: D000328:Adult; D001706:Biopsy; D003296:Cooking; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000276:immunology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000276:immunology*; D005433:Flour; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology; D012882:Skin Tests; D013997:Time Factors; D000516:alpha-Amylases / Q000009:adverse effects*
chemical_list: D007073:Immunoglobulin E; D000516:alpha-Amylases