Occupational rhinoconjunctivitis from white pepper

A 44-year-old subject developed rhinoconjunctivitis symptoms when she was exposed to white pepper while working in the food industry. A positive skin prick test for white and black pepper extracts (1:10 w/v) were obtained. Specific IgE antibodies to white and black pepper were demonstrated by ELISA. The immunoblot analysis showed two IgE-reactive protein bands able to bind to IgE from white pepper extract of 11.8 kDa and 13.6 kDa and one band from black pepper extract of 11.8 kDa. IgE binding to blotted white and black pepper extract were inhibited by preincubation of patient serum with black pepper extract. A conjunctival provocation test was positive with a white pepper extract dilution of 1:100 w/v. We describe a patient with occupational rhinoconjunctivitis caused by hypersensitivity to white pepper.