Tehran University Medical Journal

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Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.

Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut). Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.

Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%). Only five patients (2%) had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00). The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008).

Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.

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Background: Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) is a specific dermatosis of the third trimester of pregnancy, commonly seen in primigravid women.
Case presentation: A 24-year-old primigravida woman who had developed a rash immediately after delivery was admitted to Razi Hospital in Tehran, Iran. She had an erythematous eruption, particularly concentrated on the abdominal striae with umbilical sparing and involvement of limbs and extremities. Skin biopsy of the lesions on the lower abdomen, showed superficial perivascular infiltrates with occasional neutrophils and eosinophils. Both direct and indirect immunofloresence assays were negative. The patient was ultimately treated with topical clobetasol butyrate and oral chlorpheniramine for pruritus. Within a week, the lesions and the itchings had disappeared completely.
Conclusion: Pruritic urticarial papules and plaques of pregnancy are often, but not always, seen during the third trimester of pregnancy, but sometimes they present in postpartum period without any prior manifestations during pregnancy.