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Direct and airborne contact dermatitis from propolis in beekeepers

2004; Wiley; Volume: 50; Issue: 5 Linguagem: Inglês

10.1111/j.0105-1873.2004.00341g.x

1600-0536

S. Fernández, Esozia Arroabarren Alemán, Blanca Esther García Figueroa, Estíbaliz Goienetxe Fagoaga, José M. Rivera, Ana Isabel Tabar Purroy,

Insect and Arachnid Ecology and Behavior

Propolis is a lipophilic substance used by bees to seal hive walls, repair defects and preserve aseptic conditions within. Propolis is a recognized cause of occupational contact dermatitis in beekeepers, mainly from collecting honey and cleaning hives (1). Nevertheless, beekeepers now constitute less than 25% of patients with sensitization to propolis, due to its increasing use in medicinal and cosmetic preparations (2). A 50-year-old woman, a beekeeper for 20 years, developed erythema, micropapules and itching on her fingers while collecting honey. Moreover, she had a previous history of a toxic reaction after receiving more than 50 bee stings. Later on, she tolerated bee stings without any reaction. A 54-year-old man, a beekeeper for 8 years, presented with scaly eczema on his hands when cleaning the hives over the last 5 years. He had had widespread dermatitis when working as a forester some years before. A 57-year-old man, a beekeeper for the last 10 years, presented with repeated episodes of erythema and facial itching 6 h after collecting honey from hives, evolving into facial swelling within 1 D. Corticosteroid treatment became necessary to control his symptoms. Sometimes he wore a facial mask and protective spectacles but unsuccessfully. He handled honey without adverse effects. In all 3 cases, patch tests with the European standard series and with propolis 10% pet., beewax (as is), honey (as is), cinnamic alcohol 1%, vanillin 10% and benzyl cinnamate 5%, as well as a group of 13 contact allergens from plant extracts in case no. 2, were carried out, showing a positive reaction to propolis 10% pet. in all cases (case no. 1 and case no. 2: ++, case no. 3: +++). Sesquiterpene lactones (++) in case no. 2, wax (+) and nickel (++) in case no. 1 and honey (++) and wax (++) in case no. 3 were also positive. Specific immunoglobulin E against bee venom was positive only in case no. 1. Poplar bud secretion is the bee's major source of propolis and hence the origin of LB-1 (a mixture of 3 caffeic acid pentenyl esters), the major sensitizer of both propolis and poplar bud secretion. Chemical separation of various propolis samples and poplar bud extracts shows that LB-1 is always present (2); likewise, various other compounds are common to both (3). We describe 3 cases of occupational contact sensitization to propolis, with varied features. Case no. 1 was typical of such contact dermatitis in beekeepers. Shared allergens between propolis and poplar buds explain propolis sensitization in the 2nd patient (2), who had previously had contact with poplar bud secretion while working as a forester. Contact dermatitis is well recognized in foresters, though few cases related to propolis have been described (4). The 3rd patient shows an atypical form of sensitization, airborne. In the literature, only 1 case (5) of airborne contact dermatitis due to propolis has been published, within it quoted another possible similar case. In conclusion, we should consider propolis as both a direct and an airborne contact allergen in beekeepers. Likewise, in occupations with poplar contact, propolis should be considered as an allergen if dermatitis is present.