CASE HISTORY – March 2016

Contact allergy to natural allergens in a boy with atopic dermatitis

Authors: Sirje Kaur, Maire Vasar

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A 10-year-old boy was referred to the Dermatology Clinic for patch testing due to widespread, recalcitrant dermatitis. At age of 1.5 years, he had been diagnosed with atopic dermatitis (AD) and non-allergic asthma. Skin prick tests with indoor and food allergens as well as pollens were repeatedly negative. At the examination, the patient presented with papular rash on the face, neck, axillary folds and distal parts of the extremities. On hands, there were also vesicles and crusts. Patch testing with European baseline series yielded positive reactions to sesquiterpene lactone mix 2.5%, as well as to colophony 20%, Myroxylon pereirae resin 25% and formaldehyde 2% solutions, and a weak reaction to benzocaine 5%. Consequently, doctors treating patients with AD should bear in mind the possibility of contact sensitization in treatment-resistant cases of AD and refer patients for patch testing. Patients with AD should be warned about excessive use of scented cosmetics and “natural” body creams.