BackgroundMyroxylon Pereirae (Balsam of Peru) is a
dark brown, viscous, liquid mixture derived from the Central American tree Myroxylon
pereirae or Toluifera pereirae. It has a pleasant aromatic odor due to cinnamein,
an essential oil containing cinnamic acid and
vanillin.
Balsam of Peru contains 30 to 40% complex aromatic resins, many of unknown composition.
The remaining chemicals include cinnamic acid,
cinnamic alcohol,
cinnamic aldehyde,
vanillin, benzyl acetate,
benzyl alcohol,
eugenol,
isoeugenol, benzyl benzoate,
benzyl cinnamate,
benzoic acid, coniferyl benzoate, methyl cinnamate,
farnesol,
styracine, and
neroli
oil. Balsam of Peru is frequently used in standard screening patch-test
series as an indicator of
fragrance sensitivity
since it detects up to 50% of fragrance allergies. Many of the allergens found
in fragrances are either ingredients of balsam of Peru or chemically related.
Balsam of Peru is used in pharmaceuticals, fragrances, and flavorings. It has
antifungal, antibacterial, and scabicidal activity. Although the International
Fragrance Association (IFRA) recommends that balsam of Peru not be used as a
fragrance ingredient because of its sensitizing potential, it can still be found
in eg. diaper products. A positive patch-test to balsam of Peru is a marker
for spice allergy. Flare-ups of dermatitis in balsam of Peru-sensitive patients
(stomatitis, cheilitis, generalized or resistant anogenital or palmar and plantar
dermatitis) have occurred after the ingestion of spices. The peelings of citric
fruit contain essential oils that may cross-react with Balsam of Peru. Contact
allergies may also be found in backers (vanille, cinnamon) and dentists (eugenol).
SynonymsBalsam of Peru
Balsam Peru
Balsamum peruvianim
Black balsam
China oil
Honduras balsam
Indian balsam
Peruvian balsam
Surinam balsam
UsesBaby products, diaper powders
and ointments
Cosmetics, fragrances
Flavors, pastries, cakes, soft drinks,
wines, and liquours
Pharmaceuticals
Spices
Topical medications
Cross-ReactionsBalsam Tolu
Benzoates
Colophony
Cinnamates
Styrax
Benzoin
Tiger balm
Beeswax
Benzaldehyde
Benzylsalicylate
Coniferyl alcohol
Coumarin
Eugenol
Isoeugenol
Farnesol
Propanidid
Propolis
Diethylstilbesterol
Unusual
ReactionsContact urticaria
Erythema multiforme-like
Photoallergy
Phototoxic
Back to list of contact
allergens
Referenties
| 1. |
Lynde CW, Mitchell JC, Patch testing with
balsam of Peru and fragrance mix. Contact Dermatitis 1982;8(4):274-277. |
| 2. |
Veien NK. et al., Oral challenge with balsam
of Peru in patients with eczema: a preliminary study. Contact Dermatitis
1983;9(1):75-76. |
| 3. |
Veien NK. et al. Reduction of intake of balsams
in patients sensitive to balsam of Peru. Contact Dermatitis 1985;12(5):270-273. |
| 4. |
Veien NK. et al. Oral challenge with balsam
of Peru. Contact Dermatitis 1985;12(2):104-107. |
| 5. |
Veien NK. et al. Diagnostic procedures for
eczema patients. Contact Dermatitis 1987;17(1):35-40. |
| 6. |
Veien NK. et al. Can oral challenge with
balsam of peru predict possible benefit from a low balsam diet?
Am J Contact Derm 1996;7:84-87. |
| 7. |
Niinimaki A. Delayed-type allergy to spices.
Contact Dermatitis 1984;11(1):34-40. |
| 8. |
Matthies C. et al. Patch testing with fractionated
balsam of Peru. Contact Dermatitis 1988;19(5):384-385. |
| 9. |
Larsen WG. How to instruct patients sensitive
to fragrances. Journal of the American Academy of Dermatology 1989;21(4):880-884. |
| 10. |
van den Akker TW. et al. Contact allergy
to spices. Contact Dermatitis 1990;22(5):267-272. |
| 11. |
Fisher AA. Perfume dermatitis in children
sensitized to balsam of Peru in topical agents. Cutis 1990;45(1):21-23. |
| 12. |
Abifadel R. et al. Contact sensitivity to
flavourings and perfumes in atopic dermatitis. Contact Dermatitis
1992;27(1):43-46. |
Author(s):Allergology: background information on allergens.
ICD10: L23.9