Contact urticaria to Cannabis sativa due to a lipid transfer protein (LTP)

Pérez‐Ezquerra, Patricia Rojas; Sánchez-Morillas, L; Davila-Ferandez, G.; Ruiz-Hornillos, Francisco Javier; Garcia, Isabelle; Mañas, Mariana Herranz; Laguna, José Julio; Bartolomé, B

doi:10.1016/j.aller.2013.10.002

Cited by 29 publications

(17 citation statements)

References 10 publications

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“…Occupational contact urticaria to cannabis was reported in a worker of a firm who harvested cannabis for therapeutic use [37]. In this patient with primary sensitisation to pollens, prick-by-prick test with cannabis Sativa leaf yielded positive results whereas patch tests gave negative results.…”

Section: Non-edible Plantsmentioning

confidence: 77%

Occupational protein contact dermatitis

Barbaud

Poreaux

Penven

et al. 2015

European Journal of Dermatology

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Occupational contact dermatitis is generally caused by haptens but can also be induced by proteins causing mainly immunological contact urticaria (ICU); chronic hand eczema in the context of protein contact dermatitis (PCD). In a monocentric retrospective study, from our database, only 31 (0.41%) of patients with contact dermatitis had positive skin tests with proteins: 22 had occupational PCD, 3 had nonoccupational PCD, 5 occupational ICU and 1 cook had a neutrophilic fixed food eruption (NFFE) due to fish. From these results and analysis of literature, the characteristics of PCD can be summarized as follows. It is a chronic eczematous dermatitis, possibly exacerbated by work, suggestive if associated with inflammatory perionyxix and immediate erythema with pruritis, to be investigated when the patient resumes work after a period of interruption. Prick tests with the suspected protein-containing material are essential, as patch tests have negative results. In case of multisensitisation revealed by prick tests, it is advisable to analyse IgE against recombinant allergens. A history of atopy, found in 56 to 68% of the patients, has to be checked for. Most of the cases are observed among food-handlers but PCD can also be due to non-edible plants, latex, hydrolysed proteins or animal proteins. Occupational exposure to proteins can thus lead to the development of ICU. Reflecting hypersensitivity to very low concentrations of allergens, investigating ICU therefore requires caution and prick tests should be performed with a diluted form of the causative protein-containing product. Causes are food, especially fruit peel, non-edible plants, cosmetic products, latex, animals.Key words: protein contact dermatitis, chronic hand eczema, prick test, protein allergy, immunological contact urticaria, neutrophilic fixed food eruption O ccupational contact dermatitis is generally caused by haptens but it can also be induced by proteins causing immunological contact urticaria (ICU), chronic hand eczema in the context of protein contact dermatitis (PCD) or less common skin conditions. We report the results of a retrospective study on occupational protein dermatitis carried out in our dermatology and allergology department and provide an update on the characteristics of occupational skin diseases induced by proteins and on the causative factors found in our study and in a review of literature.

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Section: Non-edible Plantsmentioning

confidence: 77%

Occupational protein contact dermatitis

Barbaud

Poreaux

Penven

et al. 2015

European Journal of Dermatology

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“…Direct handling of C. sativa plants may lead to contact urticaria (13,33,36) and contact dermatitis (13). Finally, anaphylaxis can result from ingestion of hempseed (5), drinking marihuana tea (37) and smoking (38).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Cannabis sativaallergy: looking through the fog

Decuyper

Gasse

Cop

et al. 2016

Allergy

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IgE-mediated Cannabis (C. sativa, marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may trigger a C. sativa sensitization and/or allergy. The clinical presentation of a C. sativa allergy varies from mild to life-threatening reactions and often seems to depend on the route of exposure. In addition, sensitization to cannabis allergens can result in various cross-allergies, mostly for plant foods. This clinical entity, designated as the 'cannabis-fruit/vegetable syndrome', might also imply cross-reactivity with tobacco, natural latex and plant-food-derived alcoholic beverages. Hitherto, these crossallergies are predominantly reported in Europe and appear mainly to rely upon cross-reactivity between nonspecific lipid transfer proteins or thaumatin-like proteins present in C. sativa and their homologues, ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies predominantly rests upon a thorough history completed with skin testing using native extracts from crushed buds and leaves. However, quantification of specific IgE antibodies and basophil activation tests can also be helpful to establish correct diagnosis. In the absence of a cure, treatment comprises absolute avoidance measures. Whether avoidance of further use will halt the extension of related cross-allergies remains uncertain.Cannabis sativa (C. sativa) is an annual, dioecious and anemophilous flowering plant (order: Rosales, family Cannabaceae) that is native to central and southern Asia and the Caucasian region. Different preparations [dried flowering tops, hashish, hashish oil] are obtained from cannabis varieties containing elevated levels of cannabinoids, especially delta-9-tetrahydrocannabinol (THC), several of them being more or less potent psychoactive substances. Although, today, cannabis use is still illegal in most countries, it is widespread for its relaxing and euphoric effects. Furthermore, worldwide the illegal status of the drug has gained more and more resistance recently, resulting in legalization of both sale and possession of marijuana in Colorado, Alaska, Oregan and Washington, for example, both for medicinal and recreational use (1). Different European countries are debating the legalization of cannabis as well. While consumption of cannabis has been legal under certain conditions for a while

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“…37 Cutaneous contact through personal handling of plant material or occupational exposure has been associated with urticaria, generalized pruritus, and periorbital angioedema. 16,30,31,33,38,39 Anaphylaxis associated with ocular symptoms, urticaria, angioedema, dyspnea, and dysphonia has been reported with hemp seed ingestion. 15 This patient ate hemp seedeencrusted seafood (and tolerated a subsequent oral seafood challenge) and required antihistamine and epinephrine treatment.…”

Section: Legal Backgroundmentioning

confidence: 99%

“…A negative patch test result further supported the presence of an IgE-mediated reaction in this case. 38 Laboratory workers also have been reported to develop allergic rhinitis, asthma, and cutaneous symptoms with occupational Cannabis exposure. 9,16,17,39 Allergic rhinoconjunctivitis was described in a researcher with direct contact with Cannabis pollen.…”

Section: Occupational Exposurementioning

confidence: 99%