Abstract
We report a case of sialodochitis fibrinosa accompanied by urticaria and anaphylaxis-like symptoms. This 72-year-old lady had a two-year history of recurrent attacks of painful swelling of parotid glands and systemic urticaria with occasional chills and dyspnea during or shortly after meals. Results of blood tests, skin tests, and provocation tests for food allergies were all negative or within their normal ranges. Temporary elevation of serum amylase levels during the attack and the discharge of eosinophil-rich fibrin masses from the markedly dilated Steno’s duct lead us to diagnose her disease as sialodochitis fibrinosa. A skin test using patient’s saliva was negative. Although the exact mechanism of this disorder is still unknown, it seems possible that type-1 hypersensitivity occurs in both parotid glands and the skin. Therefore, this disorder should be considered if we encounter patients with both urticaria and swelling of parotid glands. To our knowledge, a total of 26 cases, including ours, have been reported in Japan, and this is the first case in the dermatological literature.
