Occupational rhinitis caused by hypersensitivity to black pepper

Summary Black pepper (Piper nigrum) rarely leads to allergic inflammation of the nasal mucosa. This is a presentation of a 52-year-old female worker exposed to black pepper dust for 10 years suffering from allergic rhinitis and chronic rhinosinusitis. She complained of nasal obstruction, rhinorrhoea, and a weakened sense of smell. Clinical examination showed the bilateral presence of polypoid lesions arising from the middle turbinate. After surgery, histopathological examination confirmed the diagnosis of inflammatory nasal polyps. Duration of exposure to black pepper and serum concentration of specific immunoglobulin E antibodies indicating work-related exposure would support a causal link between exposure to these factors and the development of chronic inflammation in the nasal mucosa. Inflammatory nasal polyps may be noted in the nasal cavity in workers exposed to black pepper dust. The absence of exposure to black pepper resulted in no detectable circulating antibodies one year after the change of workplace. This case report describes a female worker employed in the food industry, who developed allergic rhinitis associated with the appearance of inflammatory nasal polyps after several years of exposure to black pepper dust. One year after surgical removal of nasal polyps and transfer to another workplace without exposure to black pepper, there was an improvement in nasal symptoms and absence of detectability of specific immunoglobulin E to black pepper.