By Gary M. White, MD
Rarely, consumption of certain foods, food additives, or flavorings can cause a systemic contact dermatitis. Most cases are associated with positive patch testing.
Eating vanilla sugar flared a patient's eczema.
Major foods related here include citrus fruits, tomatoes, and certain spices. Since spices such as cinnamon and vanilla are related to balsam of Peru, patients must be careful of baked goods, certain condiments, and certain liquors. Other potential triggers include chocolate and colas. Ketchup consumption in children can be the culprit [Pediatr Dermatol. 2013 May-Jun;30(3):e32-3].
Cinnamon oil is used for flavoring in foods, cakes, toothpaste, chewing gum, tobacco, vermouth, aperitifs, bitters, and beverages of the cola-type.
Nickel ingestion may cause an acute vesicular hand dermatitis. An oral nickel-chelating agent, disulfiram, has shown benefit in in one study of nickel-allergic patients with hand eczema. Use of disulfiram lead to improvement in eight of nine patients.
A patient with a 1.5-year history of treatment-resistant pruritus ani was patch test-positive to nickel sulfate. History showed he consumed peanut butter daily. His symptoms resolved with dietary nickel restriction [Dermatitis. 2011 Jan-Feb;22(1):50-5].
Propylene glycol is found in many food products as well as skin and hair care products and topical medications. It may be found in a diverse range of commercial food products including salad dressing, barbecue sauce, snow cone mixes, food coloring, and sour cream.
Ingestion of chamomile, e.g., chamomile tea, may trigger a systemic contact dermatitis.
Formaldehyde is common in skin and hair care products. Formaldehyde-releasing agents may be found in foods as well. Ingestion can trigger an eyelid dermatitis. Aspartame is known to release formaldehyde.
Zinc allergy cleared over 4 months with a zinc-restricted diet. [Systemic Contact Dermatitis due to Zinc Successfully Treated with a Zinc-Restricted Diet. Allergology International 2013; 62: 265-267]
From eating soy beans daily. [Dietary Nickel as a Cause of Systemic Contact Dermatitis J Clin Aesthet Dermatol. 2009 Jun; 2(6): 39–43]
From ingesting propolis solution as a natural tonic for a few weeks. Ann Dermatol Vol. 23, No. 1, 2011
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