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Balsam of Peru Allergy — SCE Dermatology MCQ

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HardInflammatory DermatosesBalsam of Peru AllergySCE Dermatology

A patient with chronic hand and perioral eczema has a positive patch test to Myroxylon pereirae. Despite avoiding fragranced topical products, disease persists after particular foods. What mechanism should be considered?

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Correct answer: A — Systemic contact dermatitis from cross-reacting flavour chemicals

Balsam of Peru contains chemicals related to fragrance and flavour compounds found in products such as cinnamon, citrus peel, vanilla and some tomato-based foods. In selected sensitised patients, ingestion can provoke systemic contact dermatitis; dietary restriction should be targeted rather than indiscriminate.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines