title: [Systemic contact eczema against Balsam of Peru].
abstract: Balsam of Peru (PB; Myroxylon pereirae) is a natural product derived from resin of a tropical tree (MyroxyIon balsamum (L.) Harms var. pereirae (Royle) Baillon). Because of its antiseptic and aromatic properties PB or PB-components can be found worldwide not only in many health care and cosmetic products, but also in food items and semiluxury food. PB contains a wide variety of potent contact allergens leading to hypersensitivity reactions not only after topical application but also oral uptake. We report a 51-year-old brewer with chronic eczema of the hands who showed delayed-type patch test reactions against PB and fragrance-mix. Oral PB-challenge led to exacerbation of the eczema 5 and in a repeated test 2 days later. We here review this probably quite often overlooked disease and the therapeutic consequences which require profound knowledge about the wide distribution of PB when advising the patient about a PB-restricted diet. In addition, this unusual case report demonstrates that one has to consider marked delayed hypersensitivity reaction when investigating a systemic contact allergy.
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München. Wolfgang_Pfutzner@web.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pfützner
authors.forename: Andrea
authors.initials: A
authors.lastname: Niedermeier
authors.forename: Peter
authors.initials: P
authors.lastname: Thomas
authors.forename: Bernhard
authors.initials: B
authors.lastname: Przybilla
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D001453:Balsams / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005503:Food Additives / Q000009:adverse effects*; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D029904:Myroxylon / Q000009:adverse effects*; D011701:PUVA Therapy; D010592:Pharmaceutic Aids / Q000009:adverse effects*; D012882:Skin Tests; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D001453:Balsams; D005503:Food Additives; D010592:Pharmaceutic Aids; C025080:Peruvian balsam