Allergic Contact Dermatitis from Silver Birch Pollen

A 32-year-old housewife and schoolteacher presented annually from 1983 to 1986 with a seasonal April-to-September dermatitis of the exposed skin of her face, neck, and limbs, with extreme swelling of the eyelids. Her dermatitis was most severe at home, where it was not prevented by staying inside. It was improved by continuous rain, holidays by the sea, holidays abroad, and systemic steroids. She had a past history of earring dermatitis, but otherwise a completely negative personal and family history of eczema, asthma, or hay fever. She was a keen gardener.