Balsam of Peru avoidance diet

The balsam of Peru avoidance diet is a selective therapeutic intervention in systemic contact dermatitis for patients with confirmed patch test sensitization to balsam of Peru and/or fragrance mixes, indicated particularly in chronic, severe, treatment-refractory cases. Efficacy is observed in approximately 40-60% of patients, with sustained long-term benefits in most initial responders, but routine use is not recommended due to low compliance and nutritional risks.Classification of related allergens into chemical subgroups (eugenol/isoeugenol, vanillin, cinnamate, benzoate, ferulic acid, coniferyl alcohol) enables personalized recommendations: monosensitization requires selective exclusions (e.g., eugenol: cinnamon; vanillin: cloves; benzoate: preserved foods), while polysensitization demands broader restrictions (citrus, tomatoes, asparagus). Commonly excluded items: citrus fruits, tomatoes, aromatic spices, confectionery/chocolate, beverages (cola, wine), and ingestible non-food products. The diet is applied for at least four weeks, followed by gradual reintroduction to identify triggers.