A Cross-Sectional Observational Study of Clinical Spectrum and Prevalence of Fixed Food Eruption in a Tertiary Care Hospital.

BACKGROUND: Fixed food eruption (FFE) is a rare type of hypersensitivity reaction occurring after ingestion of some food items in the form of recurrent erythematous patches, bullae, vesicle, or pustule at the same site after ingestion of same or related food products. Various items listed responsible for causing FFE include tree nuts, groundnuts, legumes, lentils, eggs, fruits like kiwi, strawberry, tonic water, and tartrazine. Its more commonly reported in developed countries with no Indian studies as of yet. We studied the clinical spectrum and prevalence of FFE in a tertiary care hospital. OBJECTIVE: To study the prevalence and pattern of FFE after eliminating all other possible causes including drug rash. MATERIALS AND METHODS: A cross-section observational study of 27 consecutive patients suspected to have fixed food eruption after eliminating all possibilities of any drug reaction to the best of our knowledge. Informed consent was obtained from the patients, and ethical clearance was taken from the hospital ethical committee. RESULTS: A total of 27 patients were studied out of which 18 (66.66%) were females and 9 (33.33%) were males. The prevalence of fixed food eruption was calculated to be 0.072%.Fixed food eruption was noted secondary to cashew nuts (14.8%), almonds (7.4%), walnut (7.4%), pistachio (3.7%), strawberry (3.7%), kiwi (3.7%), and cheese crisps (3.7%). CONCLUSION: This observational study highlights the varied patterns of fixed food eruptions as well as the burden of disease in population secondary to certain diets.

Fixed Food Eruption Caused by Actinidia arguta (Hardy Kiwi): A Case Report and Literature Review.

Fixed drug eruption (FDE) is a common hypersensitivity reaction characterized by recurrent, well-circumscribed, erythematous patches that arise at the same site as a result of systemic drug exposure. However, fixed food eruption (FFE), a lesion triggered by food ingestion, is a rare allergy that was first defined in 1996. Based on their anti-inflammatory and anti-oxidant properties, the fruit and leaves of Actinidia arguta, the hardy kiwi, are widely consumed across Korea, Japan, and China. This report describes the first case of FFE caused by hardy kiwi leaves, known as Daraesun in Korean, confirmed by oral provocation tests and skin biopsy.

Occupational protein contact dermatitis.

Occupational contact dermatitis is generally caused by haptens but can also be induced by proteins causing mainly immunological contact urticaria (ICU); chronic hand eczema in the context of protein contact dermatitis (PCD). In a monocentric retrospective study, from our database, only 31 (0.41%) of patients with contact dermatitis had positive skin tests with proteins: 22 had occupational PCD, 3 had non-occupational PCD, 5 occupational ICU and 1 cook had a neutrophilic fixed food eruption (NFFE) due to fish. From these results and analysis of literature, the characteristics of PCD can be summarized as follows. It is a chronic eczematous dermatitis, possibly exacerbated by work, suggestive if associated with inflammatory perionyxix and immediate erythema with pruritis, to be investigated when the patient resumes work after a period of interruption. Prick tests with the suspected protein-containing material are essential, as patch tests have negative results. In case of multisensitisation revealed by prick tests, it is advisable to analyse IgE against recombinant allergens. A history of atopy, found in 56 to 68% of the patients, has to be checked for. Most of the cases are observed among food-handlers but PCD can also be due to non-edible plants, latex, hydrolysed proteins or animal proteins. Occupational exposure to proteins can thus lead to the development of ICU. Reflecting hypersensitivity to very low concentrations of allergens, investigating ICU therefore requires caution and prick tests should be performed with a diluted form of the causative protein-containing product. Causes are food, especially fruit peel, non-edible plants, cosmetic products, latex, animals.