Asunto(s)
Bálsamos/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dieta , Dermatosis de la Mano/diagnóstico , Adulto , Anciano , Bálsamos/administración & dosificación , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/patología , Diagnóstico Diferencial , Femenino , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/patología , Humanos , Persona de Mediana Edad , Pruebas del ParcheRESUMEN
Balsam of Peru (PB; Myroxylon pereirae) is a natural product derived from resin of a tropical tree (MyroxyIon balsamum (L.) Harms var. pereirae (Royle) Baillon). Because of its antiseptic and aromatic properties PB or PB-components can be found worldwide not only in many health care and cosmetic products, but also in food items and semiluxury food. PB contains a wide variety of potent contact allergens leading to hypersensitivity reactions not only after topical application but also oral uptake. We report a 51-year-old brewer with chronic eczema of the hands who showed delayed-type patch test reactions against PB and fragrance-mix. Oral PB-challenge led to exacerbation of the eczema 5 and in a repeated test 2 days later. We here review this probably quite often overlooked disease and the therapeutic consequences which require profound knowledge about the wide distribution of PB when advising the patient about a PB-restricted diet. In addition, this unusual case report demonstrates that one has to consider marked delayed hypersensitivity reaction when investigating a systemic contact allergy.