Allergic Contact Dermatitis from Propolis

Susan E. Walgrave; Erin M. Warshaw; Lynn A. Glesne


Dermatitis. 2005;16(4):209-215. 

In This Article

Reactions to Ingested Propolis

The ingestion of propolis can also have deleterious effects resulting in allergic contact cheilitis, stomatitis, perioral eczema, labial edema, oral pain, and dyspnea. Several cases have been described after patients have consumed various propolis products such as tablets, toothpaste,[78] mouthwash, and propolis lozenges.[79] Bellegrandi and colleagues described a patient infected with human immunodeficiency virus-1 (HIV-1) who developed painful ulcers of the mouth, followed by labial and oral swelling, dyspnea, and labial and perioral eczema. Treatment with antiviral and antifungal agents were unsuccessful. It was later determined that the patient had been taking propolis drops. Stopping this resulted in a remission of symptoms. The result of patch testing with propolis (20% pet) in this patient was positive. Eight healthy subjects and 10 HIV-positive patients without a history of allergy also underwent patch testing. None reacted to propolis.[79]

There are at least eight compounds[10,33,80–82] and as many as 13 compounds[9] that propolis and balsam of Peru have in common. Some of these compounds include benzyl benzoate, cinnamyl cinnamate, and benzyl cinnamate.[33] Several studies have suggested that patients who are sensitive to propolis also may react to balsam of Peru[9,10,53,83] although these studies are not consistent, and not all patients who react to propolis react to balsam of Peru and vice versa. This is most likely due to the variability of the components contained in propolis, depending on where the trees were grown and where the propolis was extracted. It is on the basis of the findings of common components that these reactions have been termed "pseudocross-reactions" and not true cross-reactions.[33]