Patch Test Reactions Associated with Food Sources: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001-2018)

Authors

• Jonathan I. Silverberg, From the, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
• Seung Hyun Cheong, Department of Dermatology, Konyang University Hospital, Daejeon, Republic of Korea.
• Erin M. Warshaw, Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
• Joel G. DeKoven, Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
• Brandon L. Adler, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
• Melanie D. Pratt, Division of Dermatology, University of Ottawa, Ontario, Canada.
• Donald V. Belsito, Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA.
• Amber R. Atwater, Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA.
• Marie-Claude Houle, Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada.
• Cory A. Dunnick, Department of Dermatology, Rocky Mountain Regional VAMC, Aurora, Colorado, USA.
• Jiade Yu, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
• James S. Taylor, Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA.
• Margo J. Reeder, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
• Vincent A. DeLeo, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
• Christen Mowad, Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
• Nina C. Botto, Department of Dermatology, University of California San Francisco, San Francisco, California, USA.

Document Type

Journal Article

Publication Date

3-2-2026

Journal

Dermatitis : contact, atopic, occupational, drug

DOI

10.1177/17103568261421385

Abstract

Contact dermatitis due to food exposure is underrecognized. To characterize relevant allergens associated with food sources and analyze patient and clinical characteristics associated with food-related allergen exposure in patients with a currently relevant positive patch test reaction (PPTR). We retrospectively analyzed North American Contact Dermatitis Group data from 2001 to 2018, identifying relevant allergens linked to food sources. Patients with currently relevant PPTRs were divided into food-related and non-food-related exposure groups for comparison. Among 43,722 patients, 867 (2.0%) had at least one currently relevant food-related PPTR, accounting for 936 PPTR reactions. The most common allergens were nickel (411, 43.9%), Balsam of Peru (BOP, 287, 30.7%), and fragrance mix 1 (FM1, 60, 6.4%). Carvone (24/139 [17.3%]) and sodium metabisulfite (10/87 [11.5%]) showed the highest food-related proportions. Among 867 food-related patients, the most commonly affected areas were generalized (30.22%) and the hand (19.26%). Patients having food-related PPTR were significantly less likely to involve the hand (OR, 0.59; P < 0.0001) and face (OR, 0.43; P < 0.0001) as compared with nonfood-related patients. Food exposure was associated with a higher likelihood of anogenital dermatitis (P ≤ 0.01 for nickel sulfate, BOP or FM1). Nickel, BOP, and FM1 were the most common food-related allergens. Common sites of dermatitis in patients with food-related PPTR were generalized, anogenital areas, and hands, although involvement of the hands and face was significantly less likely compared with nonfood-related cases.

APA Citation

Silverberg, Jonathan I.; Cheong, Seung Hyun; Warshaw, Erin M.; DeKoven, Joel G.; Adler, Brandon L.; Pratt, Melanie D.; Belsito, Donald V.; Atwater, Amber R.; Houle, Marie-Claude; Dunnick, Cory A.; Yu, Jiade; Taylor, James S.; Reeder, Margo J.; DeLeo, Vincent A.; Mowad, Christen; and Botto, Nina C., "Patch Test Reactions Associated with Food Sources: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001-2018)" (2026). GW Authored Works. Paper 8950.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8950

Department

Dermatology