34767 Kombucha-induced irritant contact dermatitis

A 30-year-old woman presented with a 2-month history of an intermittent rash on the bilateral upper cutaneous lip. Rash was originally thought to be early herpes simplex, but was unresponsive to a 7-day course of valacyclovir. Patient noted the rash to appear during periods of increased consumption of kombucha, a fermented tea. She had only been applying petrolatum to the area. She had no history of atopy, and no significant medical history. She worked in a hospital without any significant occupational exposures. On the upper cutaneous lip there were 2 symmetrically placed pink macules. The presumed diagnosis was an irritant contact allergy in response to the increased consumption of kombucha. The patient was advised to decrease consumption of kombucha, with resolution of the rash occurring within 1 week. Kombucha is a slightly sweet and acidic beverage made of fermented black tea and a symbiotic culture of yeasts and bacteria. Believed to first have originated in China, it has recently gained popularity due to its potential health benefits; however, there remain a paucity of benefits reported in literature. To our knowledge, this is the first report of a kombucha-induced irritant contact dermatitis, which is likely due to the high pH (approximately 2.8) of the fermented tea. This case highlights the importance of a thorough history in patients with suspected contact dermatitis with emphasis on both topical products as well as herbal remedies.