Salicylate Allergy (including Aspirin).

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Calnan and others describe a number of cases of contact dermatitis of the lips which were traced to allergy to salicylate. The dermatitis spread in a ring around the mouth. Calnan et al

In a 17-year prospect study of allergic reactions to aspirin conducted in the USA, the following points were found to be especially important. (1) the common manifestation is urticaria/angioedema: the second most common, asthma. (2) women of child-bearing age are especially prone to develop aspirin sensitivity, otherwise the age of onset is approximately equal in the two sexes, varying from one year to sixty years. (3) although an immunologic basis of aspirin sensitivity has not been demonstrated, 90% of its victims are also sensitive to inhalants (76%), foods (74%) or drugs (43%). (4) the study could not confirm the widely held view that aspirin cross-reacts with tartrazine. (5) it was also unable to confirm another widely held view that asthmatic patients who are sensitive to aspirin have a strong tendency to develop nasal polyps. (6) the prognosis of asthma in patients sensitive to aspirin does not differ from that of patients who are not. Speer F et al

     In a study of 21 patients with aspirin hypersensitivity in Spain, some patients suffered from several types of allergic symptoms -- eleven from asthma, three rhinitis, three edema, five urticaria and two anaphylactic shock. Pina J.et al

     To determine salicylate content, 333 food items were analyzed in a USA study. This is the most comprehensive set of data on food salicylates yet published. Most fruits, especially berry fruits and dried fruits, contain salicylate. Vegetables show a wide range from 0 to 6 mg salicylate per 100 gm food (for gherkins). Some herbs and spices contain very high amounts per 100 gm, e.g., curry powder, paprika, thyme, garam masala, and rosemary. Among beverages, tea provides substantial amounts of salicylate. Licorice and peppermint candies and some honeys contain salicylates. Cereals, meat, fish, and dairy products contain none or negligible amounts. Swain AR et al

     Urticaria may accompanied by sensitivity to Aspirin or food additives. Reaction to Aspirin and food additives was tested on 131 patients in England with chronic urticaria, by means of oral provocation tests . A total of 31 patients showed a reaction to Aspirin challenge. In 19 of 23 Aspirin sensitive patients, positive reactions to one or more food additives were observed. Doeglas HM

     The following beliefs about Aspirin sensitivity are widely held according to a study from the USA: (1) it usually is accompanied by nasal polyps. (2) it occurs primarily in nonallergic patients. (3) its most common manifestation is asthma. (4) when it is combined with polyps and asthma (the so-called "Aspirin triad"), the prognosis is unfavorable. (5) polypectomy may precipitate asthma in Aspirin sensitive patients. This study of 112 patients refutes these beliefs. It shows the following: (1) Aspirin allergy is accompanied by polyps in less than 5% of cases (13% of asthma patients). (2) in most cases, patients show well-defined allergy to an inhalent, food, or other drug. (3) its most common manifestations are urticaria and angioedema, not asthma. (4) the prognosis is favorable, whether or not polyps are present. (5) polypectomy does not precipitate asthma in Aspirin-sensitive patients. Speer F

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REFERENCES

Calnan CD. Cronin E. Rycroft RJ Allergy to phenyl salicylate. Contact Dermatitis. 7(4):208-11, 1981 Jul. 82116119

Doeglas HM. Reactions to Aspirin and food additive in patients with chronic urticaria, including physical urticarias. British Journal of Dermatology. 93 (2): 135-44, 1975 Aug. 76018887

Pina J. Barbado A. Marques D. Leitao MC. Duarte C. Gomes MJ. Amaral-Marques R. Our experience with acetylsalicylic acid and hypersensitivity. Allergologia et Immunopathologia. 12 (3): 217-23,1994 May-June. 84303791

Speer F. Denison TR. Baptist JE. Aspirin allergy. Annals of Allergy. 46 (3): 123-6,1985 Mar. 81131734

Speer F Aspirin allergy: a clinical study. Southern Medical Journal. 68 (3): 314-8,1975 Mar. 75121958

Swain AR. Dutton SP. Truswell AS. Salicylates in foods. Journal of the American Dietetic Association. 85 (8): 950-60,1985 Aug. 85262472

 This page was last reviewed on 18th Aug 2004