Anafilaxia por contacto con leche en un adulto con alergia alimentaria. Reporte de caso

: Antecedentes: La alergia a proteinas de leche de vaca es la alergia alimentaria mas frecuente y su prevalencia se ha incrementado en la ultima decada. Aunque la mayoria de los pacientes presenta sintomas por ingestion, se ha descrito sensibilizacion cutanea y de mucosas. Caso clinico: Hombre de 31 anos, chef de profesion, en quien se iniciaron sintomas orofaringeos despues de la ingesta de leche. No suprimio de su dieta otros productos lacteos que toleraba en ese momento, sin embargo, los cuadros alergicos fueron progresando y se anadieron manifestaciones cutaneas; finalmente presento anafilaxia por contacto con masa de pan que contenia mantequilla y leche. El paciente fue atendido en urgencias, donde se comprobo la elevacion de la triptasa serica. Las pruebas cutaneas y serologicas resultaron positivas para leche y sus derivados. Conclusion: La anafilaxia por contacto con leche es infrecuente y solo se ha informado en ninos. Consideramos que la manipulacion repetida de alimentos pudiera favorecer la sensibilizacion cutanea en adultos con historia personal de atopia. CASE REPORT: A 31-year-old male patient who is a professional chef and started with oropharyngeal symptoms after the intake of milk. Since he tolerated other dairy products, he did not suppress them from his diet. However, the clinical picture progressed and cutaneous symptoms were added; finally, anaphylaxis occurred by contact with bread dough that contained butter and milk. The patient was treated in the emergency department, where an increase in serum tryptase was verified. Skin prick tests and serological tests were positive for milk and its fractions. CONCLUSION: Reports of anaphylaxis caused by dermal contact with cow's milk are very scarce and they have been reported only in children. We believe that repeated food handling could favor cutaneous sensitization in adults with a personal history of atopy.