title: Contact urticaria on eczematous skin by kiwifruit allergy. In vivo component-resolved diagnosis.
abstract: BACKGROUND
  Kiwifruit allergy has been responsible for a variety of clinical manifestations, ranging from mild reactions, such as localised oral symptoms, to severe systemic symptoms, such as anaphylaxis. No cases of isolated contact urticaria (ICU) due to IgE-mediated allergy to kiwifruit have been reported in the literature so far. Here we describe the first three cases of ICU due to kiwi and we hypothesise about a kiwifruit allergen not described yet.
  
  
  METHODS
  Using the available in vivo allergy tests, we performed a component-resolved diagnosis to detect the allergen involved. All the patients underwent prick-by-prick with raw and boiled kiwi pulp and latex glove, skin prick test with commercial extracts of kiwifruit, birch, latex, palm profilin and peach lipid transfer protein, rub test with raw and boiled kiwi and oral food challenges with the raw fruit.
  
  
  RESULTS
  We found that, in our patients, the kiwifruit allergen responsible for ICU is thermolabile, gastrosensitive, and it does not show any of the most common kiwi-attributed cross-reactivity (latex, birch, profiling and lipid transfer protein). None of the 13 kiwifruit allergens already known shows all these features.
  
  
  CONCLUSIONS
  Kiwifruit allergy can also occur with ICU, probably due to a native protein that is not yet identified. In this case the elimination diet is not required.
authors.affiliation: Department of Pediatrics, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy. Electronic address: smicelisopo@rm.unicatt.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Miceli Sopo
authors.affiliation: Department of Pediatrics, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fantacci
authors.affiliation: Department of Pediatrics, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Sani
mesh_terms: D029042:Actinidia / Q000009:adverse effects* / Q000276:immunology; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005638:Fruit / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D012882:Skin Tests; D014581:Urticaria / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology
keywords: Contact urticaria; Food allergy; Kiwi fruit