Anaphylaxis after topical goat milk exposure
IT MAY be unwise for people with eczema to use topical products containing food allergens, a specialist has warned.
Allergy and immunology specialist Dr Raymond Mullins has reported the case of a woman who had an episode of goat cheese-induced anaphylaxis after using goat milk soaps and moisturiser to treat dry skin and mild eczema.
Dr Mullins, from John James Medical Centre in Canberra, said the woman began using the goat-derived products in 2009, then noticed an “itchy mouth” while eating goat cheese in 2010 and developed tongue and throat swelling after eating goat cheese in 2011.
“In early 2012 she experienced generalised urticarial, upper airway angioedema, bronchospasm and confusion after she accidentally ate goat cheese, requiring treatment with adrenaline,” he wrote in a letter to the Medical Journal of Australia.
Although the patient tolerated dairy products, skin prick tests proved positive to cow, sheep and goat milks and cheeses as well as to goat milk soap.
Dr Mullins said the woman’s topical exposure to food allergen in goat milk products may have sensitised her to later oral ingestion of goat products.
“While association is not equivalent to causation, precedents for occupational and other topical exposures as risk factors for systemic allergic reactions to food are well described, and underpin the prudence of using non-food emollients for eczema control,” he wrote.
Med J Aust 2012; 197:148-49