Anaphylaxis to cutaneous exposure to milk protein in a diaper rash ointment

A 12-month-old boy, with a strong history of cow's milk allergy, developed two episodes of anaphylaxis following cutaneous application of a casein containing ointment to an inflamed diaper area. RAST testing showed a significant elevation in specific IgE antibodies to milk and milk proteins. This experience suggests that children who are highly sensitive to milk may have severe allergic reactions on cutaneous exposure to milk or milk products.