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Introduction
Peanut allergy is being increasingly recognised and prevalence is reported to be in the range of 1-3 per cent for the population. There are no sequential data which accurately report the prevalence of peanut allergy in the UK population, but in common with other allergic conditions, the available evidence indicates that the prevalence is increasing.1
Although the risk of peanut allergy after ingestion of peanut containing foods is well recognised, the role of peanut oil as an allergen is controversial. Peanut oil, otherwise known as arachis oil, is the refined fatty oil obtained from the seeds of Arachis hypogaea L (peanut). This part of the nut has not been associated with allergic reactions in individuals with peanut allergy.
The Chief Medical Officer's update in August 20032 advised that there was insufficient evidence to conclude that exposure to medicinal products containing peanut oil leads to sensitisation to peanut protein. However, although the risk of an allergic reaction is low, as a precaution the Committee on Safety of Medicines (CSM) has advised that:
1
Patients known to be allergic to peanuts should not use medicines containing peanut oil.
2
As there is a possible relationship between peanut allergy and soya allergy, patients allergic to soya should also avoid medicinal products containing peanut oil.
For a practising otolaryngologist this is highly relevant as one of the most widely prescribed products, Naseptin® (Alliance), contains peanut oil. We therefore carried out a survey to find out how well this advice was followed. The following case report shows the increasing public awareness of peanut allergy.
Case report
A nine-year-old boy was seen in clinic with a history of recurrent epistaxis and examination revealed prominent vessels on the anterior nasal septum. These were treated with silver nitrate and the boy was prescribed Naseptin cream to be applied to the affected area for two weeks. The next morning the consultant was contacted by the boy's mother who informed him that her son had been excluded from school because his teacher had a severe nut allergy. Despite the best efforts of the consultant to reassure the headmaster that the likelihood of the teacher coming into contact with the cream was very remote indeed and probably less than coming into contact...