title: Two Cases of Occupational Contact Urticaria Caused by Percutaneous Sensitization to Parvalbumin.
abstract: BACKGROUND
  In recent years, it has been proposed that the primary mechanism for the development of food allergies is percutaneous sensitization. Since 2010, in Japan, the number of immediate-type wheat allergy due to hydrolyzed wheat protein has dramatically increased among those who have been using soap containing hydrolyzed wheat. This incidence supports the hypothesis that food allergens arise through percutaneous sensitization.
  
  
  CONCLUSIONS
  A 25-year-old man (case 1) and an 18-year-old girl (case 2) with atopic dermatitis visited our Department because of food allergy and hand eczema. After starting their work with fish, severe itchy eczema appeared on their hands. They subsequently started to experience oral allergic symptoms, intraoral itchiness and dyspnea after eating fish. Specific IgE antibodies were detected for many fishes, and skin prick tests showed positive reactions for a variety of fishes in both cases. Furthermore, the fluorescence intensities of specific IgE antibodies against parvalbumin from various types of fish in microarray immunoassay analysis showed positive reactions. We diagnosed them as contact urticaria caused by percutaneous sensitization to parvalbumin through job-related physical contact with fish.
  
  
  CONCLUSIONS
  The patients' histories and findings indicate the possibility of percutaneous sensitization through occupational exposure to parvalbumin, leading to food allergy.
authors.affiliation: Department of Integrative Medical Science for Allergic Disease, Toyoake, Japan ; Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Akiyo
authors.initials: A
authors.lastname: Sano
authors.affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Yagami
authors.affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan ; Department of Dermatology, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Iwata
authors.affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Tsukane
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Arima
authors.affiliation: Department of Pediatrics, Second Teaching Hospital of Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Integrative Medical Science for Allergic Disease, Toyoake, Japan ; Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsunaga
keywords: Contact urticaria; Occupational allergy; Parvalbumin; Percutaneous sensitization