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Lettuce

Common name:	Lettuce
Botanical name:	Lactuca sativa (milk sap)
Family:	Asteraceae (Compositae)
Origin:	Lettuce originates from the wild Lactuca serriola found in the Mediterranean and Near East (Persia).
Description:	All lettuce cultivars such as Cos, Leaf, Butterhead and Iceberg are regarded as being variants of Lactuca sativa. Lettuce has been transformed from an erect plant with bitter leaves to various cultivars including ones with distinctive heads of chlorophyll deficient leaves. The common and Latin name derive from the milky sap (latex) found in all parts of the plane {lac, lactis = milk}. The latex has a milky sedative effect and lettuce has been grown as an herb. {Note: there is no cross-reaction between lettuce latex and natural rubber latex}.

Uses:	A large number of different cultivars of lettuce have been bred and are now grown all over the World, mainly for use in salads.
Allergens:	Lactucin, lactucopicrin (?sesquiterpenes)
Allergy:	Lettuce is an occasional cause of allergic contact dermatitis particularly in food handlers, chefs and market gardeners. It tends to cause hand dermatitis, which spreads up the forearms. Unfortunately immediate hypersensitivity to lettuce has also been reported. This includes Urticaria and life threatening anaphylaxis. The allergy seems to cross react with chicory and endives so these vegetables may need to be avoided as well.
Cross reactions:	Chicory and endives
Other information:	Paintings of what appear to be Cos Lettuce have been found in Egyptian tombs dating back to as early as 4500 BC although there is some uncertainty about their identity. The first authenticated records of cultivated lettuce date back to Greek historical records in 450 BC. In the first century AD the Romans were growing a number of different cultivars.
Patch test:	Leaf as is, sesquiterpene lactone mix

References

San Miguel-Moncin M, Krail M, Scheurer S, Enrique E, Alonso R, Conti A, Cistero-Bahima A, Vieths S. Lettuce anaphylaxis: identification of a lipid transfer protein as the major allergen. Allergy. 2003 Jun;58(6):511-7.
Pelsser LM, Buitelaar JK. [Favourable effect of a standard elimination diet on the behavior of young children with attention deficit hyperactivity disorder (ADHD): a pilot study]. Ned Tijdschr Geneeskd. 2002 Dec 28;146(52):2543-7. Dutch.
Birmingham N, Thanesvorakul S, Gangur V. Relative immunogenicity of commonly allergenic foods versus rarely allergenic and nonallergenic foods in mice. Food Prot. 2002 Dec;65(12):1988-91.
Avila Castanon L, Perez Lopez J, del Rio Navarro BE, Rosas Vargas MA, Lerma Ortiz L, Sienra Monge JJ. [Hypersensitivity detected by skin tests to food in allergic patients in the Hospital Infantil de Mexico Federico Gomez.]. Rev Alerg Mex. 2002 May-Jun;49(3):74-9. Spanish.
Enrique E, Cistero-Bahima A, Bartolome B, Alonso R, San Miguel-Moncin MM, Bartra J, Martinez A. Platanus acerifolia pollinosis and food allergy. Allergy. 2002 Apr;57(4):351-6.
Paulsen E, Andersen KE, Hausen BM. Sensitization and cross-reaction patterns in Danish Compositae-allergic patients. Contact Dermatitis. 2001 Oct;45(4):197-204.
Beezhold DH, Reschke JE, Allen JH, Kostyal DA, Sussman GL. Latex protein: a hidden "food" allergen? Asthma Proc. 2000 Sep-Oct;21(5):301-6.
Franck P, Kanny G, Dousset B, Nabet P, Moneret-Vautrin DA. Lettuce allergy. Allergy. 2000 Feb;55(2):201-2.
Escudero A, Bartolome B, Sanchez-Guerrero IM, Palacios R. Lettuce and chicory sensitization. Allergy. 1999 Feb;54(2):183-4.
Vila L, Sanchez G, Sanz ML, Dieguez I, Martinez A, Palacios R, Martinez J. Study of a case of hypersensitivity to lettuce (Lactuca sativa). Clin Exp Allergy. 1998 Aug;28(8):1031-5.
Paulsen E, Sogaard J, Andersen KE. Occupational dermatitis in Danish gardeners and greenhouse workers (III). Compositae-related symptoms. Contact Dermatitis. 1998 Mar;38(3):140-6.
Garcia Ortiz JC, Cosmes PM, Lopez-Asunsolo A. Allergy to foods in patients monosensitized to Artemisia pollen. Allergy. 1996 Dec;51(12):927-31.
Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Dermatitis. 1996 Sep;35(3):157-62.
Cadot P, Kochuyt AM, Deman R, Stevens EA. Inhalative occupational and ingestive immediate-type allergy caused by chicory (Cichorium intybus). Clin Exp Allergy. 1996 Aug;26(8):940-4.
Schwartz HJ, Arnold JL, Strohl KP. Nasal response to carrot and lettuce challenge in allergic patients. Ann Allergy Asthma Immunol. 1995 Feb;74(2):152-4.
Helbling A, Schwartz HJ, Lopez M, Lehrer SB. Lettuce and carrot allergy: are they related? Allergy Proc. 1994 Jan-Feb;15(1):33-8.
Alonso MD, Martin JA, Cuevas M, Parra F, Lezaun A, Conde Salazar L, Guimaraens MD, Losada E. Occupational protein contact dermatitis from lettuce. Contact Dermatitis. 1993 Aug;29(2):109-10.
Grazioli I, Melzi G, Balsamo V, Castellucci G, Castro M, Catassi C, Ratsch JM, Scotta S. [Food intolerance and irritable bowel syndrome of childhood: clinical efficacy of oral sodium cromoglycate and elimination diet]. Minerva Pediatr. 1993 Jun;45(6):253-8. Italian.
Oliwiecki S, Beck MH, Hausen BM. Compositae dermatitis aggravated by eating lettuce. Contact Dermatitis. 1991 Apr;24(4):318-9
Howland WC 3rd, Simon RA. Sulfite-treated lettuce challenges in sulfite-sensitive subjects with asthma. J Allergy Clin Immunol. 1989 Jun;83(6):1079-82.
De Luca L. [Behavior of bronchial reactivity in 50 children before and after exclusion of food allergens]. Pediatr Med Chir. 1988 Nov-Dec;10(6):617-20. Italian.
Taylor SL, Bush RK, Selner JC, Nordlee JA, Wiener MB, Holden K, Koepke JW, Busse WW. Sensitivity to sulfited foods among sulfite-sensitive subjects with asthma. J Allergy Clin Immunol. 1988 Jun;81(6):1159-67.
Hausen BM, Andersen KE, Helander I, Gensch KH. Lettuce allergy: sensitizing potency of allergens. Contact Dermatitis. 1986 Oct;15(4):246-9.
Panush RS, Stroud RM, Webster EM. Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. Arthritis Rheum. 1986 Feb;29(2):220-6.
Fregert S, Sjoborg S. Unsuspected lettuce immediate allergy in a case of delayed metal allergy. Contact Dermatitis. 1982 Jul;8(4):265.
Krook G. Occupational dermatitis from Lactuca sativa (lettuce) and Cichorium (endive). Simultaneous occurrence of immediate and delayed allergy as a cause of contact dermatitis. Contact Dermatitis. 1977 Feb;3(1):27-36.
Lovell CR.1993, Plants and the Skin, Blackwell, Oxford.
Mitchell JC, Rook A, 1979, Botanical Dermatology, Plants and Plant products injurious to the skin, Greengrass, Vancouver.
Botanical Dermatology Database.