Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome.
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.
Anliker
Mark David
MD
Dermatology Unit, Department of Medicine, Kanton Hospital of Aarau, Aarau, Switzerland.
Borelli
Siegfried
S
Wüthrich
Brunello
B
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*
D007073:Immunoglobulin E