Propolis contact allergy

What is propolis?

Propolis is the glue made by bees to build, repair, and protect their hives. It consists of partially digested resins from a variety of tree buds and bark mixed with beeswax. In Europe, it is derived mainly from poplar shoots, but conifers are also used. Propolis, therefore, is a complex mixture comprising balsams and resins, waxes, essential oils, pollen and cinnamyl alcohol, vitamins A, B, C and E, flavonoids and minerals.

A number of other substances related to propolis can be listed as ingredients, particularly of cosmetics. Cera flava is the yellow wax produced from a honeycomb. Cera alba is the bleached form of Cera flava. It is used as an emulsifying and thickening agent in cosmetics and as a food additive (E901) for coating and glazing candies and fresh fruits. Other substances related to propolis include propolis wax, beeswax acid, and synthetic beeswax.

who gets in touch allergic reactions to propolis and why?

Propolis is becoming more and more important allergen, with European studies reporting positive patch Test rates from 1.2 to 6.6%. In a series from Finland, the rate increased from 0.5% in 1995-7 to 1.4% in 2000-2. Another study in children reported an increase from 2% to 13.7% between 1995 and 2002; The 75% of the patch-tested children had used a natural product or alternative medicine remedy. In a 2010 Polish patch test study with children with chronic recurrent eczema and atopy, a positive propolis patch test was recorded in 16.5% of children aged 7 to 8 years and in 5.4% of adolescents aged 16 to 17 years. Propolis was the second most common positive patch test positive allergen after nickel in children and the fourth most common in adolescents.

Paradoxically, contact stomatitis and allergic contact cheilitis to propolis have been reported in a HIVpositive patient taking a propolis 30% solution orally.

Exposure to propolis and propolis-related substances can occur in multiple settings.

Occupational

• Beekeepers – propolis allergy it can develop after many years of exposure. In one study, the average time of exposure before developing allergy to propolis was 9.5 years (range 0.1-35 years).
• Violinists and fiddlers: Propolis has been a component of Italian varnish for centuries.
• Cobblers: Beeswax is used for the seams of handmade boots and may be contaminated with propolis.
• Woodcutters, including forestry workers and farmers, specifically cutting aspens.
• Artists – beeswax moldings

Cosmetic products

• facial creams
• Lipsticks and balms
• depilatory waxes

oral hygiene products

• Toothpaste
• Mouthwash

Therapeutic use

• Propolis has been widely used in natural therapeutic products due to its purported antiseptic, anti-inflammatory, anesthetic and antioxidant properties.
• Propolis is advocated as a natural steroid and chemical free alternative.
• Natural therapeutic products containing propolis include mouth drops, cough syrups, ointments, lotions, drops, and oral pills.
• Propolis has been commonly implicated in contact allergies complicating chronic venous insufficiency (5%) and anogenital disease (2.5%).

Food

• Honey – Although propolis is usually removed entirely, it can be added for its purported therapeutic effect
• Brightness: in fruits, candies, chewable vitamins, gum

reinforcing agent

• Ointments and creams

Modified-release oral preparations

• To adjust the melting point of suppositories.

Biocosmetics and biotherapeutics appear to be the most common source of exposure to propolis in those sensitized.

The oldest Allergens In poplar-derived propolis, the cocoons are caffeine. 3-methyl-2-butenyl caffeate and phenylethyl caffeate are the main sensitizers. Benzyl caffeate, geranyl caffeate, benzyl salicylate, benzyl cinnamate, methyl cinnamate, ferulic acid, and tectochrysin are also sensitizers present in propolis.

Propolis allergy often cross-reacts with pereirae by myroxylon (balsam of Peru) since there are 13 known constituents in common. Other recognized cross-reactions due to shared ingredients (commonly cinnamic acid, cinnamyl alcohol, vanillin) include:

• Rosin

• Fragrance Blend I

• Carnauba wax (from the Brazilian carnauba palm): used as an edible gloss finish.

Cross-reaction with beeswax is rare but can occur, possibly due to contamination with propolis.

Contact with propolis can be direct or, less frequently, in the air.

What are the clinical features of allergy to propolis?

Contact allergy to propolis results in dermatitis or urticaria. Symptoms and signs include:

• Itching, burning, pain
• Located swelling of the lips and tongue
• Located eruption

  • hand dermatitis – common presentation

    • eczematous
    • psoriasiform (I like it palmoplantar psoriasis)
    • redness, small bumps, itching
  • eczematous rash around the mouthperioral eczema)

  • cheilitis – redness, climbing and crust of the lips

  • stomatitis, including mouth ulcers

  • violinist's neck
  • facial redness, itching, and swelling if due to air contact
• Urticaria
• Throat complaints: difficulty swallowing or speaking
• Systemic symptoms such as shortness of breath

• Autosensitizing dermatitis (rash at a site distant from primary contact) has been reported.

Reactions begin within hours to days of exposure in a previously sensitized patient. Initial sensitization it takes 10 to 15 days.

How is propolis allergy diagnosed?

Diagnosis of allergy to propolis is made by patch testing with 10% propolis in petrolatum and the probable source “as is” or diluted, eg honey, cosmetic or therapeutic formulation. An outbreak of original dermatitis has been reported in association with positive patch test reactions.

What is the treatment for allergy to propolis?

Avoidance of propolis-containing products results in resolution of the reaction, but sometimes an additional unidentified source of propolis exposure causes milder symptoms to persist. Therefore, it is important to reassess if contact allergy symptoms do not fully resolve despite avoiding the original source of propolis.

Beekeepers with allergic contact dermatitis on the hands due to propolis may continue to work with hives wearing rubber or leather gloves.

In a case, ingestion of propolis-enriched honey as a capsule had no effect despite perioral cheilitis/eczema and positive patch test for honey and propolis.

Patients with known allergies to conifers, poplars, salicylates, and Myroxylon sloths are advised to avoid propolis due to allergenic constituents It is important to note the names of substances related to propolis, as they should also be avoided.

Dermatitis is usually treated with emollients and current steroids Hives are treated with oral antihistamines.