Hypersensitivity reaction to the ingestion of mango flesh

Abstract

A 42-year-old woman presented with a hypersensitivity reaction after the ingestion of a small amount of fresh mango gelato. She developed itchy palpable purpuric lesions over her arms, legs, neck and abdomen 4 days after ingestion. The lesions persisted for 5 weeks despite treatment with betamethasone-17 valerate 0.05% ointment and avoidance of mango. Resolution of these lesions was eventually achieved with continuing treatment. The patient denied any prior contact with mango skin but had experienced previous sensitizing reactions to mango flesh. Patch testing was strongly positive to mango skin and mango flesh. Skin-prick testing was negative. This case describes a systemic contact dermatitis to mango flesh, an entity less common than allergic contact dermatitis.

Hypersensitivity manifestations to the fruit mango

“…Ten of these patients (four with immediate reaction [6, 7, 9, 10]; six with delayed reaction [11, 15, 16]) were reported from geographical areas cultivating mango. Five of these patients were documented from Australia [11, 16], two each from Spain [6, 9] and India [10] and one patient from Thailand [15] (Table 1).…”

“…Five of these patients were documented from Australia [11, 16], two each from Spain [6, 9] and India [10] and one patient from Thailand [15] (Table 1). Twelve patients (six with immediate reaction [2-5, 8]; six with delayed reaction [1, 12-14, 17]) were reported from the countries where large scale mango cultivation does not occur.…”

Patch Testing with Various Mango (Mangifera indica) Extracts

“…Type IV allergic contact dermatitis in sensitized patients can be caused by the oleoresin of the mango tree sap or the skin of the fruit, or allergic cheilitis from eating mango. [2] Besides, type I anaphylactic reaction can follow ingestion of mango. [3][4][5] Miell et al used prick test with mango juice (0.1ml), melon juice (0.1ml), mango juice (0.1ml diluted one in 10 with physiological saline), and physiological saline as the diagnostic tool for type I anaphylactic reaction without patch tests in their report [5].…”

Exacerbação da asma por hipersensibilidade imediata ao consumo de manga

“…(9)(10)(11)(12)(13)(14)(15)(16) The paucity of data regarding allergic manifestations to mango prompted this description of a 46-year-old female patient with immediate hypersensitivity reaction after the ingestion of fresh mango. The patient had nasal symptoms for 4 years which were followed by wheezing dyspnea and cough for 2 years.…”

“…(12,14) Three of those twelve patients developed the symptoms after ingesting mango, (9,12,14) whereas the remaining nine patients developed the reaction after contact with mango skin or the bark of the mango tree. (10,11,13,15,16) Patch testing was performed in ten patients, (10,(12)(13)(14)(15)(16) and the result was positive in all ten. Cross-reactivity and positivity for specific IgE antibodies against mango antigen were not reported in any patient.…”