Patch Test Reactions Associated with Food Sources: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001-2018).

Background

Contact dermatitis due to food exposure is underrecognized.

Objectives

To characterize relevant allergens associated with food sources and analyze patient and clinical characteristics associated with food-related allergen exposure in patients with a currently relevant positive patch test reaction (PPTR).

Methods

We retrospectively analyzed North American Contact Dermatitis Group data from 2001 to 2018, identifying relevant allergens linked to food sources. Patients with currently relevant PPTRs were divided into food-related and non-food-related exposure groups for comparison.

Results

Among 43,722 patients, 867 (2.0%) had at least one currently relevant food-related PPTR, accounting for 936 PPTR reactions. The most common allergens were nickel (411, 43.9%), Balsam of Peru (BOP, 287, 30.7%), and fragrance mix 1 (FM1, 60, 6.4%). Carvone (24/139 [17.3%]) and sodium metabisulfite (10/87 [11.5%]) showed the highest food-related proportions. Among 867 food-related patients, the most commonly affected areas were generalized (30.22%) and the hand (19.26%). Patients having food-related PPTR were significantly less likely to involve the hand (OR, 0.59; P < 0.0001) and face (OR, 0.43; P < 0.0001) as compared with nonfood-related patients. Food exposure was associated with a higher likelihood of anogenital dermatitis (P ≤ 0.01 for nickel sulfate, BOP or FM1).

Conclusion

Nickel, BOP, and FM1 were the most common food-related allergens. Common sites of dermatitis in patients with food-related PPTR were generalized, anogenital areas, and hands, although involvement of the hands and face was significantly less likely compared with nonfood-related cases.