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Recalcitrant atopic dermatitis due to allergy to Compositae
M Wintzen1, A S Donker, E J van Zuuren
1Department of Dermatology, Leiden University Medical Center, the Netherlands. mwintzen@knmg.nl
Contact Dermatitis
|April 16, 2003
Summary
Allergic contact dermatitis can complicate atopic dermatitis. A Compositae mix (CM) allergy was identified in a patient through patch testing, linked to dietary intake of Compositae foods, improving her skin condition upon exclusion.
Area of Science:
- Dermatology
- Allergology
- Clinical Immunology
Background:
- Atopic dermatitis (AD) frequently coexists with allergic contact dermatitis (ACD).
- Patch testing is crucial for diagnosing ACD, but interpreting positive reactions can be challenging.
- Identifying the relevance of specific allergens is key to effective patient management.
Observation:
- A 35-year-old woman presented with severe, treatment-resistant atopic dermatitis.
- Patch testing revealed a positive reaction to Compositae mix (CM).
- Initial assessment suggested past relevance, possibly due to calendula exposure.
Findings:
- The patient consumed a diet rich in Compositae family food products.
- Excluding these specific foods from her diet led to rapid improvement in her skin condition.
- This indicated a direct link between dietary Compositae intake and her ACD flare-ups.
Implications:
- Positive patch tests require thorough investigation to determine allergen relevance.
- Dietary sources, particularly from the Compositae family, can be significant unrecognized contact allergens.
- This case highlights the importance of comprehensive patient history and dietary analysis in managing complex dermatological conditions.