Patients with systemic, lip, and oral contact allergy will often improve with an elimination diet of related ingredients. Elimination diets for avoidance of many common preservatives, antioxidants, and other food additives have not been published.
Objective
This study aims to create rational elimination diets (including lists of acceptable alternative foods) for several common food ingredients (propylene glycol, sorbic acid/sorbates, aspartame, benzoic acid/benzoates, propionic acid and propionates, gallates, and benzoyl peroxide).
Methods
Data from www.foodfacts.com, a Web site listing ingredient information for more than 75,000 foods, were extracted and sorted into products types, and an elimination diet was created for each of these food-related substances. Easily obtainable alternatives were identified and listed.
Conclusions
Use of food elimination diets may yield improvement in some patients who have not improved with external avoidance of allergens.
HjorthN. Allergy to balsams. Spectrum Int. 1965; 7: 97–101.
8.
HjorthN. Eczematous Allergy to Balsam, Allied Perfumes, and Flavoring Agents [Thesis]. Denmark: University of Copenhagen;. 1961.
9.
HjorthN. Eczematous allergy to balsams, allied perfumes, and flavoring agents with special reference to balsam of Peru. Acta Dermato-Venereologica, 1961; 46: 102–111.
10.
FisherAA. The management of propylene glycol-sensitive patients. Cutis, 1980; 25: 24.
FisherAA. Contact dermatitis due to cinnamon and cinnamic aldehyde. Cutis, 1975; 16: 838.
21.
NiinimakiA. Double-blind placebo-controlled peroral challenges in patients with delayed-type allergy to balsam of Peru. Contact Dermatitis, 1995; 33: 78–83.
22.
VeienNK, HattelT, LaurbergG. Can oral challenge with balsam of Peru predict possible benefit from a low-balsam diet?. Am J Contact Dermat, 1996; 7: 84–87.
23.
BelsitoDV. Surviving on a balsam-restricted diet. Cruel and unusual punishment or medically necessary therapy? J Am Acad Dermatol, 2001; 45: 470–472.
24.
MitchellJC, CalnanCD, ClendenningWE, et al.Patch testing with some components of balsam of Peru. Contact Dermatitis, 1976; 2: 57–58.
25.
FowlerJF Jr. Systemic contact dermatitis caused by oral chromium picolinate. Cutis, 2000; 65: 112.
FregertS.Sensitization to hexa- and trivalent chromium. In: LiebnerE, FlorianE, eds. Pemphigus; Occupational Dermatosis due to Chemical Sensitization. Budapest, Hungary: Hungarian Dermatological Society; 1965: 50–55.
29.
VeienNK, KaaberK. Nickel, cobalt, and chromium sensitivity in patients with pompholyx (dyshidrotic eczema). Contact Dermatitis, 1979; 5: 371–374.
30.
SrivastavaD, CohenDE. Identification of the constituents of balsam of Peru in tomatoes. Dermatitis, 2009; 20(2): 99–105.
31.
CroninE, DiMichaelAD, BrownSS. Oral challenge in nickel-sensitive women with hand eczema. In: BrownSS, SundermanFWJr, eds. Nickel Toxicology. New York, NY: Academic; 1980: 149–155.
32.
ChristensenOB, MollerH. External and internal exposure to the antigen in the hand eczema of nickel allergy. Contact Dermatitis, 1975; 1: 136–141.
33.
OzkayaE, TopkarciZ, OzarmaganG. Systemic allergic dermatitis from chromium in a multivitamin/multimineral tablet. Contact Dermatitis, 2010; 62: 184.
34.
KaaberK, VeienNK, TjellJC, et al.Low nickel diet in the treatment of patients with chronic nickel dermatitis. Br J Dermatol, 1978; 98: 197–201.
35.
KaaberK, MenneT, TjellJC, et al.Antabuse treatment of nickel dermatitis; Chelation—a new principle in the treatment of nickel dermatitis. Contact Dermatitis, 1979; 5: 221–228.
36.
BurrowsD, CreswellS, MerretJD. Nickel, hands and hip prosthesis. Br J Dermatol, 1981; 105: 437–444.
37.
GoitreM, BedelloPO, CaneD. Su due casi di dermatite da nickel. Giorno Italian Dermatol Venereol, 1981; 116: 43–45.
38.
PercegueiroM, BrandaoM. Oral nickel administration in sensitized individuals [in Portuguese]. Med Cután Ibero Lat Am, 1982; 10: 295–298.
39.
SertoliA, LombardiP, FrancalanciS, et al.Effetto della somministrazione oracle de apteni in soggetti sensibilizzati affecting da eczema allergizo de contatto. Giorno Italian Dermatol Venereol, 1985; 120: 207–218.
40.
GawkrodgerDJ, CookSW, FellGS, et al.Nickel dermatits: the reaction to oral nickel challenge. Br J Dermatol, 1986; 115: 33–38.
41.
VeienNK, HattelT, JustesenO, et al.Oral challenge with nickel and cobalt in patients with positive patch tests to nickel and/or cobalt. Acta Dermato-Venereologica (Stockholm), 1987; 67: 321–325.
42.
NeilsenGD, JepsenLV, JorgensenPJ, et al.Nickel-sensitive patients with vesicular hand eczema: oral challenge with a diet naturally high in nickel. Br J Dermatol, 1990; 122: 299–308.
43.
VeienNK, HattelT, JustesenO, et al.Dietary treatment of nickel dermatitis. Acta Dermato-Venereologica (Stockholm), 1985; 65: 138–142.
44.
GoitreM, BedelloPG, CaneD. Chromium dermatitis and oral administration of the metal. Contact Dermatitis, 1982; 8: 208–209.
45.
HannukselaM. Food allergy and skin diseases. Ann Allergy, 1983; 51: 269–272.
AugustPJ.Successful treatment of urticarial due to food additives with sodium cromoglycate and an exclusion diet. In: PepysJ, EdwardsAM, eds. The Mast Cell: Its Role in Health and Disease. Bath, UK: The Pitman Medical; 1979: 584.
57.
FisherAA. Hand dermatitis- A “baker’ dozen”. Cutis, 1982; 29: 214–221.
