Citrus fruit allergy

Allergy to citrus fruits, e.g. petit grain, orange, lemon, lime, grapefruit, mandarin, orange and bergamot, e.g. orange oil, nerolioil.

Recently, the number of cases has decreased to such an extent that citrus fruits have disappeared as a test component from the standard series. In the past, people working in the fruit industry, canning and peeling (canned fruit, jam) in particular suffered from contact dermatitis. Today, sensitization is still occasionally diagnosed in vegetable or fruit merchants. Cheilitides have also become known.

One famous case was that of anal eczema in a young girl whose father, a fruit merchant, forced the family members to use the tissue paper used to wrap the oranges as toilet paper. This was caused by the essential oils leaking from the peel into the tissue paper. The preservative applied to the peel in the country of origin to protect the oranges from rotting can also be the cause of contact eczema. This is less likely to be caused by diphenyphenol, which used to be widely used, but rather by thiabendazole (imidazole derivative), an antifungal agent and fungicide that has been used almost exclusively in recent times. A person allergic to this substance must avoid contact with both sprayed citrus fruits and athlete's foot products containing imidazole.

1. Ono R et al. (2015) A case of food-dependentexercise-induced anaphylaxis caused by ingestion of orange. Arerugi 64:149-155
2. Turner PJ et al. (2011) Anaphylaxis to apple and orange seed. J Allergy C 128:1363-1365.
3. Lorio RA et al. (2013) Citrus allergy from pollen to clinical symptoms. PLoS One 8:e53680.