Spice allergy and Allspice allergy are both uncommon, and it is estimated that around 2% of food allergy reactions in adults are caused by spices. Spices have the potential for being hidden food allergens. The allergenic proteins in spices are not well characterized and commercial skin testing extracts are not available, thus limiting widespread clinical testing. Spice allergy is likely being under diagnosed.
Common spices that are reported to cause allergies include mustard, coriander (cilantro), fennel, saffron, parsley and cumin. Case reports have also been described with oregano, thyme, caraway seed and cayenne pepper. Allspice, also known as Jamaican pepper is a common ingredient in several foods like ketchup, curry powder, jerk seasoning, stews and several spiced desserts. In Europe, allspice is mainly used in desserts like pumpkin pie, bread pudding, spice cakes and gingerbread. Allspice is also used in herbal therapies and as a perfume for soaps.
Because there are no commercially available skin testing commercial extracts for most spices, direct prick-to-prick testing, with the spice in question can be performed. Dry food such as spices, can be crushed or grinded, and mixed with saline to do the prick-to-prick testing
A prick-to-prick test involves pricking the fresh food with an allergy pricking device and then pricking the skin. The test is read after 15 minutes and a wheal/flare is indicative of a positive test. Some spices can also elicit an irritating reaction on skin prick-to-prick testing, positive and negative controls should be performed as well.
The most definitive form of testing for food allergies, is an oral food challenge when a patient directly ingests the food. This is done in a controlled environment, typically in an allergists office, where resuscitative equipment is available and most especially, where epinephrine can be administered in case of an anaphylactic reaction.
Spice allergy and allspice allergy can cause symptoms of an anaphylactic reaction, symptoms can include, hives, swelling of the lips/tongue, shortness of breath, wheezing, vomiting and diarrhea.
Management of a spice allergy or an allspice allergy is strict dietary avoidance. Although this can be difficult as spices are often sold as blends and manufacturers may not list individual spices in prepared foods. Thus both spice and allspice can be a potential hidden allergen when it is an ingredient.