Mango dermatitis: An unusual cause of eyelid dermatitis in France

Abstract

A 30-year-old female patient was referred for recurrent erythematous swelling of the right eyelid for 2 years, associated with a discrete vesicular cheilitis (Figure 1). She also reported a few occurrences of palatal mucosal damage and an isolated episode of erythematous rash on both thighs. The lesions persisted each time for 1 week. She was first diagnosed with and treated for recurrent herpes simplex virus infection. She had lived in the USA between 1998 and 2005 as a teenager and had experienced at least one unexplained acute vesiculo-bullous hand dermatitis while living in New-Caledonia between 2014 and 2016. She also reported a history of allergic contact dermatitis to tea tree oil and to a scented shower gel. Further questioning revealed that she suspected ingestion of some exotic fruits such as mango, pineapple and passion fruit in the triggering of mucocutaneous lesions. Patch tests were carried out on the upper back, using IQ ultra TM patch test chambers (Chemotechnique, Vellinge, Sweden) occluded for 2 days with Oper tape (Iberhospitex, Innovative Health Technologies, Barcelona, Spain) and included the European baseline series along with additional tests from the REVIDAL group, cosmetic series, fresh mango pulp and peel, and fresh pulp of pineapple and passion fruit. Tests were read at day (D)2 and D3, according to the ESCD criteria. Positive reactions were observed for limonene hydroperoxide 0.3% pet. (+? on D2 and ++ on D3), tea tree oil 5% pet. (+ on D2 and ++ on D3), with a past relevance for the first two and a current relevance for fresh mango pulp and skin (++ on D2 and D3) (Figure 2). DISCUSSION