Occupational contact urticaria and late-phase bronchial asthma caused by compositae pollen in a florist

Insect-pollinated members of the plant family Compositae (Asteraceae) rarely cause immediate-type hypersensitivity disease; however, this may have quite disabling consequences, which is shown by the case of a 42-year-old female florist. She developed contact urticaria later accompanied by rhinoconjunctivitis and bronchial asthma with maximum obstruction occurring some hours after the end of occupational exposure to the causative Compositae pollens of, for example, dandelions, blazing star, golden rod, yarrow, Aster ssp, chrysanthemums, and marguerite. Skin testing revealed immediate-type hypersensitivity to several members of the above-mentioned plant family confirmed by demonstration of specific IgE antibodies. Bronchial provocation testing yielded a positive response with all 4 pollen extracts tested. The patient had to give up work in a flower shop, because sufficient avoidance of airborne inhalant exposure was not considered practical.