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Dermatitis from cashew nuts.

J G Marks, T DeMelfi, M A McCarthy

    Journal of the American Academy of Dermatology
    |April 1, 1984
    PubMed
    Summary
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    Imported cashew nuts caused a poison ivy-like rash in 54 people. Patch testing showed cashew allergens are similar to poison ivy, but didn't predict who got sick.

    Area of Science:

    • Dermatology
    • Toxicology
    • Allergology

    Background:

    • Poison ivy-like dermatitis outbreaks have been linked to cashew nut consumption.
    • Urushiol, the allergen in poison ivy, shares structural similarities with compounds found in cashew nut shells.

    Purpose of the Study:

    • To investigate the cause of a dermatitis outbreak linked to imported cashew nuts.
    • To determine if cashew nut shell components cross-react with poison ivy urushiol.

    Main Methods:

    • Clinical observation of 54 patients with dermatitis after consuming cashew nuts.
    • Patch testing of 19 volunteers (11 ill, 8 well) with poison ivy urushiol and cashew nut shell extract.
    • Mass spectrometry analysis of cashew shell extract.

    Main Results:

    Related Experiment Videos

    • Fifty-four individuals developed pruritic, erythematous, maculopapular eruptions after eating imported cashew nuts.
    • Patch testing showed positive reactions to both poison ivy urushiol and cashew extract in both ill and well individuals, indicating cross-reactivity but poor illness prediction.
    • Mass spectrometry suggested the presence of cardol, a known cashew allergen, in the cashew shell extract.

    Conclusions:

    • The dermatitis outbreak was likely caused by allergens in cashew nut shells, specifically cardol, which cross-reacts with poison ivy urushiol.
    • Patch testing with cashew extract and urushiol demonstrates cross-reactivity but is not a reliable predictor of illness in this context.
    • The absence of cashew shells in some consumed products may explain the lack of correlation between patch test results and observed illness.