myroxylon pereira

[Rachel J]

After going for patch tests I was told I was allergic to myroxylon pereirae. The information sheet I was given listed the things I should avoid, including spices. I am still experiencing mild symptoms (problems with my tongue tingling and swelling slightly) that are inconvenient and uncomfortable rather that painful. Is there any way I can easily identify which spices I am reacting to? It is incredibly difficult to avoid all spices. (I am also allergic to fragrance mix 1 and 2 and nickel.)

I was also wondering how long after exposure to the substance I am reacting to would cause my tongue to swell, would it be something I had eaten immediately before the swelling started or earlier in the day?

[Dr Faheem Latheef]

Dear Rachel,
Thanks your question. Are you able to expand on what prompted you to be referred for the patch testing in the first instance? Did you have eczema/dermatitis or some other rash or was it purely due to the mouth problems? We often see Myroxylon Pereira (Balsam of Peru) coming up positive on patch testing along with other fragrances in people particularly suffering from dermatitis where this is caused by various fragrances, including the Balsam of Peru, being present in their personal care products. However we also do see these reactions in people who get referred with a sore mouth or lip problems where it is contact with the spices or bakery products containing these allergens that is the problem.

Balsam of Peru smells of vanilla and cinnamon because it contains 60-70% cinnamein (a combination of cinnamic acid, cinnamyl cinnamate, benzyl benzoate, benzoic acid and vanillin). It can therefore be found in the following flavourings:
Citrus fruit peel
Baked goods and confectionary
Cola and other soft drinks
Aperitifs, e.g. vermouth, bitters
Spices, e.g. cinnamon, cloves, vanilla, nutmeg, paprika, curry

In terms of how long it takes from exposure to developing a reaction this would not be immediate as the reaction picked up on a patch test represent what is referred to as a delayed hypersensitivity reaction which typically takes 48 to 72 hours (can be seen earlier) which is why we take the patch test readings at these points. The reactions also tend to last for a few days.

Once you identify what you are allergic to we would advise that it may take up to 8 weeks of avoidance to notice an improvement in your symptoms.

Hope this answers your question and all the best!