title: Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome.
abstract: Protein contact dermatitis to meat is well known in butchers; spices are another source of potential contact allergy and usually are not recognized. We present a first case of contact-dermatitis to spice mix in a 39-year-old-butcher. The patient underwent skin prick testing (SPT) with standard allergens (ALK) and different meat and spice extracts (Stallergènes), scratch-patch testing with spice mix containing glutamate, paprika and other spices. Specific serum-IgE was measured with CAP-FEIA. SPT only showed an immediate-type sensitization to mugwort (+ +), as well as different spices (paprika +, curry +, cumin +) and camomile (+ + +). Scratch-patch tests were negative for different meat, but strongly positive for spice mix (+ + +) after 30 min (wheal and flare) and (+ +) after 48 h (infiltration and vesiculation). Two healthy controls were tested negative for spice mix used from that patient (scratch-patch). Specific IgE was slightly elevated for paprika 0.47 kU/L (CAP class 1), anise 0.43 kU/L, curry 0.36 kU/L and mugwort 3.83 kU/L. Sx1 atopy-multiscreen was 3.8 kU/L due to a sensitization to mugwort alone. The tests performed demonstrate an IgE-mediated contact allergy to spices but also a delayed type allergy to spice mix as a manifestation of the mugwort-spice syndrome in this individual. When testing for occupational dermatitis in butchers, protein contact allergy to spices must also be taken into consideration.
authors.affiliation: Dermatology Unit, Department of Medicine, Kanton Hospital of Aarau, Aarau, Switzerland.
authors.forename: Mark David
authors.initials: MD
authors.lastname: Anliker
authors.forename: Siegfried
authors.initials: S
authors.lastname: Borelli
authors.forename: Brunello
authors.initials: B
authors.lastname: Wüthrich
mesh_terms: D000328:Adult; D019306:Artemisia / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000276:immunology*; D009783:Dermatitis, Occupational / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D012882:Skin Tests; D017365:Spices / Q000009:adverse effects*
chemical_list: D007073:Immunoglobulin E