Case Infants and children who have severe egg allergies and/or eczema have a higher risk of tree nut allergies. A 7 year old boy was presented to an emergency room complaining of generalized wheals and dyspnea after 5 - 10 minutes of bathing with Japanese Yuzu. Pediatricians diagnosed anaphylaxis and administered an intramuscular injection of epinephrine. Then, he was referred to a dermatology clinic to determine the culprit allergens. He had a complication of atopic dermatitis and a history of anaphylaxis caused by cashew nuts. His symptom of atopic dermatitis was moderate disease according to investigator's global assessment. His parents had eaten cashew nuts at home and also made homemade seasonings with yuzu. He also experienced itchy oral discomfort when he drank a pectin-containing fermented milk product. From cross-sensitization among cashew nut, pectin, and citrus fruits had been reported. Has been suspected that the transdermal allergic reaction to yuzu bath additives. Researchers performed a skin prick test that revealed strong reactions to cashew nuts, pistachios, yuzu endocarp, ingredients that belonged in the bath additives, pectin from citrus, and a pectin-containing fermented milk product.
