Contact Dermatitis Associated with Food: Retrospective Cross-Sectional Analysis of North American Contact Dermatitis Group Data, 2001-2004

BACKGROUND Allergic and irritant contact dermatitis to food is likely underreported. OBJECTIVES To characterize relevant allergens and irritants associated with food in patients referred to the North American Contact Dermatitis Group (NACDG) for patch testing. METHODS Retrospective analysis of cross-sectional data from the NACDG from 2001 to 2004. RESULTS Of 10,061 patch-tested patients, 109 (1.1%) had a total of 122 reactions associated with food. Approximately two-thirds of patients (66%) were female, and one-third (36%) were atopic. The hands were the most common sites of dermatitis (36.7%). There were 78 currently relevant (definite, probable, or possible) allergic reactions to NACDG standard series allergens with a food source; the most common allergen was nickel (48.7%), followed by Myroxilon pereirae (balsam of Peru) (20.6%) and propylene glycol (6.4%). Twenty allergic reactions to non-NACDG standard allergens and 24 relevant food irritants were also identified. Overall, 21% (25 of 122) of all reactions (irritant and allergic) were occupation related; the majority of these (17 of 25) were relevant irritant reactions. Cooks were the most commonly affected occupational group (40%). CONCLUSIONS In this limited data set, nickel, Myroxilon pereirae, and propylene glycol were the most common allergens identified with a food source. Of food-related occupational disease, irritation was more common than allergy.