Tropical Fruit Allergies in Dermatology: Mango Cross-Reactivity and Cutaneous Manifestations

Mango (Mangifera indica), an immensely common tropical fruit, has become a major but lesser known source of allergic reactions to food, especially those that damage the skin. Pistachio, cashew, poison oak and poison ivy are all members of the Anacardiaceae family. They share allergenic chemicals including urushiol and lipid transfer proteins, which help explain their complex clinical presentation and cross-reactivity. Both immediate (Type I) and delayed (Type IV) hypersensitivity reactions can be brought on by a mango allergy. Urticaria, angioedema, oral allergy syndrome (OAS) and in rare instances anaphylaxis are typical type I reactions. These are frequently brought on by allergens such as profilins and are mediated by IgE antibodies. Conversely, type IV reactions which often show up 8–72 hours after exposure are characterized by allergic contact dermatitis after skin contact with mango peel, sap or tree components. Even after being exposed to mangos for the first time, people who have previously become sensitized to plants that contain urushiol including poison ivy, may show increased sensitivity. Due to symptoms that coincide with those of other dermatoses such as atopic dermatitis, irritating contact dermatitis and skin disorders linked to pandemic masks, diagnosing mango allergy can be clinically challenging. Certain IgE assays, skin prick tests and patch testing are crucial tools for differentiating between various forms of hypersensitivity. Case studies show a range of manifestations from widespread systemic reactions to localized perioral dermatitis and they point out that workers in the food business are especially vulnerable to occupational allergies. According to studies, mango is the most prevalent fruit allergy in places like Taiwan and China. Geographical and nutritional factors affect prevalence. Mango allergies are mainly unreported and poorly understood. Effective care depends on improved clinician awareness, precise diagnosis and knowledgeable patient education. Further study is required to better understand cross-reactivity mechanisms, create more precise diagnoses and investigate possible immunotherapies. For prompt treatment and to avoid misdiagnosis, mango allergy must be acknowledged as a unique and important dermatological entity.