Allergic symptoms due to silk dress*1

Rationale Allergy to silk is a well-known occupational hazard in sericulture. Immediate cutaneous and respiratory symptoms due to silk clothing are rare. Methods A 13-year-old woman suffered from asthmatic symptoms and urticaria while wearing a wild silk dress. Skin prick tests were performed with different kinds of silk. Specific IgE for wild silk and cultivated silk were measured using CAP Pharmacia technique. A challenge test was performed, previous informed consent, by exposure to her silk dress. A spirometry was carried out before and after the challenge test. Results The skin prick tests were positive (wheal >3 mm) for all kinds of silk tested. Specific IgE for wild silk was 0,51 ku/l (CAP 1), and 2,81 ku/l (CAP 2) for cultivated silk. After the exposure to the silk dress, the patient developed, immediately, itching and hives in contact areas, as well as conjunctival congestion, that relieved with antihistaminic treatment. Both spirometries, before and after the challenge test, were normal. Conclusions A case of a 13-year-old woman that suffered from asthmatic and cutaneous symptoms due to a silk dress is presented. In this case a mediated IgE response to silk was proved.