I get all the peaches now!
July 16, 2014 4:14 PM   Subscribe

Food allergy contact dermatitis is a thing? A *different* thing?

Mr. NGE got an itchy rash on his hand and arm last night. Washed it off, put anti itch cream on it, gone. Weird. Thought no more of it. In the middle of the night he got up and ate another of the rapidly ripening peaches he's been living on. Woke up with his hand covered with itchy rash.

We brought some science down on this shit: I cut open a peach and rubbed the juice on his arm. He rinsed it off after about 1 minute. ITCHY RASH all over the test spot.

Here's the weird: he says he has no itching in his mouth after he eats them.

He has severe asthma and might well have bitch pollen allergy, so I'm guessing this is cross sensitivity as per Mayo Clinic website. He will go to an allergist early next month at the latest.

My questions are, is this a normal manifestation of cross reactive allergy? Especially with the non itchy mouth? I can't find any description of this reaction anywhere from the Goog. Is there anything to do about this before seeing an allergist? Has anyone heard of this weird reaction pattern before?

posted by The Noble Goofy Elk to Health & Fitness (14 answers total) 1 user marked this as a favorite
Hives as a manifestation of a food allergy is totally normal and common. It doesn't always co-occur with mouth itching or anything like that, and it may or may not be related to his other allergies. Food allergies can basically start at any time, and they can get worse and worse with repeat exposure, so it would be a good idea for him to avoid peaches from now on.
posted by brainmouse at 4:18 PM on July 16, 2014 [1 favorite]

Also, though, uticartia is one of the symptoms of anaphylaxis, and it's totally possible to get some symptoms and not others. According to wikipedia, the skin reaction is the most common.

Again, allergic reactions can get get more and more serious with repeated exposure, so he should really abstain from now on.

And note that basically all (first-line) allergy testing is done with skin testing and looking for a skin response, even if that is not the primary reaction when the food is eaten, so it is not surprising that your skin testing would promote a skin response.
posted by brainmouse at 4:32 PM on July 16, 2014 [1 favorite]

Best answer: I don't have lots of food allergies, but I do get a rash on my lips if they touch mango. If I can get it into my mouth without touching my lips, I'm fine. I developed this phenomenon well into adulthood and I've been eating mangoes like a nut since I was a kid. I have cut-back quite a bit on my mango eating as allergies can get worse quickly and I don't want to end up with a more severe problem.
posted by quince at 4:36 PM on July 16, 2014

Best answer: IANAD but my sister is allergic to cantaloupe and butternut squash and yams and (edited to add) mangoes (and various pollens and animals, but no other foods). Only her lips and hands/arms are affected by these four foods, so if she can maneuver these foods into her mouth without the food or any drips from it touching her lips or hands, she can eat it. I know when this started she was in high school and at that time, our doctor told her that eating these foods was OK. She does sometimes, but usually abstains because it's really hard to eat anything without bits of it touching your lips. Obviously I have no idea if this is the same for your husband-- I suggest a call to the doctor sooner rather than later.
posted by holyrood at 4:37 PM on July 16, 2014

Best answer: This is totally a thing. I get a reaction on my hands if I have been cutting potatoes or eggplant, but I have never had any reaction to eating these things - though admittedly I've never tried eating them raw, as they would be when I am handling them.
posted by Cheese Monster at 4:41 PM on July 16, 2014

Best answer: Absolutely contact dermatitis is a thing. I've heard of a lot of different fruits doing this - my brother and sister in law did a work-your-way-around-the-world backpacking trip before they were married, and had to abandon one temp job they got picking mangoes on a farm in Australia because they were getting seriously bad rashes.
posted by EmpressCallipygos at 4:47 PM on July 16, 2014

Best answer: I get mango rash too, but only from contact with the skins or the sap from the tree. If I wash the mangos off with soap after I pick them I never have a problem.

I don't think it's related to food allergies.
posted by kanewai at 5:39 PM on July 16, 2014

Response by poster: The way an allergist explained it to me a few years ago was that my itchy mouth when I eat a bannana is due to a sympathetic reaction because I'm allergic to the plant itself (and it's many cousins) but that isn't a True Food Allergy. And I was told to stop eating bananas, because it could get dangerously worse without warning.

What perplexes me about this situation is that he has no itchy mouth! No hives or anything after he eats peaches, except where the delicious, yummy nectar touched his skin.

I'm guessing this is most like the mango run ins described above. But I will advise asking the allergist before he eats another peach.

Thanks so much, all!!!
posted by The Noble Goofy Elk at 6:31 PM on July 16, 2014

Yeah, this is totally a thing. My husband can't handle raw butternut squash or zucchini without getting a weird skin reaction on his hands, but he can eat them cooked with no problem.
posted by bedhead at 9:33 PM on July 16, 2014 [1 favorite]

Best answer: Yeah, it sounds like potential cross-reactivity / Oral Allergy Syndrome (my boyfriend has birch pollen allergies with a cross-reactivity to peaches and I've seen him have a skin reaction from touching foods he's allergic to), although the lack of a reaction upon eating it is actually a bit weird. The mango rash that some folks are describing in the thread is also a real phenomenon (I have it too!), but unrelated -- it's not caused by cross-reactivity with pollen allergy, it's because mango skin and sap has urushiol (the same irritant that's in poison ivy) in it.
posted by phoenixy at 1:31 AM on July 17, 2014

Best answer: My husband can't handle raw butternut squash or zucchini without getting a weird skin reaction on his hands, but he can eat them cooked with no problem.

Per my allergist, that's because the specific proteins he's allergic to are denatured by the heat of cooking (he also mentioned that there is no study he's aware of that has looked at what temperatures will denature which proteins).

Skin rash, as mentioned above, can be a symptom of anaphylaxis, which can easily--and, again per my allergist, very suddenly--go from hives to your throat swelling shut. Get to an allergist sooner rather than later. Keep Benadryl around the house. Just because he's only had skin-contact allergic reactions so far it doesn't necessarily mean he'll never have other reactions. Anecdata: one of my instructors in culinary school was deadly, as in on the ground choking in about thirty seconds, allergic to any and all shellfish. Her allergy started as only a skin-contact thing.

From a handy sheet I was given by my allergist, from foodallergy.org, regarding food allergies and anaphylaxis:

Severe symptoms:

Lung - shortness of breath, wheezing, repetitive cough
Heart - pale, blue, faint, weak pulse, dizziness
Throat - tight, hoarse, trouble breathing or swallowing
Mouth - significant swelling of the tongue and/or lips
Skin - Many hives over body, widespread redness
Stomach - repetitive vomiting or severe diarrhea
Other - feeling something bad is going to happen, anxiety, confusion

For any of those symptoms, inject epinephrine immediately (don't rely on antihistamines), dial 911, ask for an ambulance with epi onboard.

Mild symptoms:
Nose: itchy/runny nose, sneezing
Mouth: itchy mouth
Skin: a few hives, mild itch
Stomach: mild nausea/discomfort

For any one of those give antihistamines if ordered by physician. If symptoms persist and/or worsen, or more than one of these symptoms are present, as above inject epi and call 911.

It's actually pretty important to go to the ER with allergic reactions (and really not a good idea to test them at home), because there can be what's called a biphasic reaction: initial reaction, followed by further reactions 4-8 hours later. My allergist also told me you can come into contact with whatever you're allergic 500 times and be fine, and the 501st you're suddenly choking. Or the first time. Allergies, he said, are weird like that.

So like I said... allergist the soonest you can get an appointment with one. If it's financially realistic for you, consider having your PCP prescribe an epi-pen just in case. (They run about $140 here, have to be replaced every year).
posted by feckless fecal fear mongering at 7:10 AM on July 17, 2014

(IANAD in case that wasn't obvious)
posted by feckless fecal fear mongering at 7:12 AM on July 17, 2014 [1 favorite]

Since he has severe asthma, I'm assuming he's got it well under control. My wild theory generator suggests that may be why he's not reacting orally.

When I started reacting to peaches it was just on the skin, too. Until it wasn't. I almost don't miss them anymore.
posted by monopas at 4:35 PM on July 17, 2014 [2 favorites]

Response by poster: Good grief! Epi-pen it is. (Cash poor/FSA rich to the rescue again!)

Mangos having that poison ivy/oak chemical in them, that's going to give me nightmares.
posted by The Noble Goofy Elk at 9:11 PM on July 17, 2014

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