Allergic contact dermatitis from sorbitans in beer and bread.

Sorbitol-derived compounds have been increasingly recognized as a cause of delayed hypersensitivity reactions. We present a case of recurrent allergic contact dermatitis (ACD) that lasted 6 months in which the patient retrospectively correlated new lesion appearance with consumption of specific types of beer and bread. Patch testing using the North American Contact Dermatitis Group Standard Series with supplemental allergens was positive for sorbitan sesquioleate (SSO) and sorbitan monooleate (SMO). Avoidance of beer and bread led to complete clinical resolution. Sorbitol in beer and bread is not well documented but likely is related to the yeast cultures used for fermentation and leavening. Sorbitol is utilized as an osmotic stabilizer in yeast culture preparation and is found in commercially prepared brewer's and baker's yeasts. We propose that trace amounts of sorbitans in yeast-containing products can cause ACD. Systematized ACD poses a challenge for dermatologists to diagnose, as the pattern can be nonspecific and skin testing does not always produce meaningful results. Because it is difficult to elicit history and correlate exposures with worsening of skin symptoms, a trial of dietary avoidance may be necessary to determine the diagnosis of systematized ACD. When patch testing is positive for SSO and SMO, the dermatologist should inquire about dietary habits with attention to beer and bread.

Nutraceuticals: A Review.

Skin aging is continuously influenced by various internal and external factors such as the biologic progression of cells, ultraviolet (UV) radiation, tobacco, nutritional deficiencies, and hormonal imbalances that lead to the degradation of skin cells. Through the degradation of skin cells, free radicals and inflammation weaken repair mechanisms and result in collagen and elastic fiber breakdown. The appearance of aging skin is highlighted by skin roughness, wrinkling, pigmentation change, telangiectasias, loss of elasticity, and decreased firmness, all of which are accelerated by these internal and external factors. Throughout the years, nutraceuticals have been studied to delay and fight against these internal and external factors, many of which are found in foods and byproducts consumed naturally. The aim of this review is to aid dermatologists in understanding the mechanism of action of popular nutraceuticals and their possible efficacy in antiaging and skin health.