Síndrome de Frey simulando eritema malar por alergia alimentar Frey's syndrome simulating malar fl ushing by food allergy

Objective: To report a case of Frey syndrome in a child, whose malar fl ushing has been initially associated with food allergy. Case description: One year-old child referred to the food allergy out-patient clinic. The patient has been presenting unilateral facial fl ushing localized in the auriculotemporal nerve pathway after the ingestion of fruits and vegetables. At this time, these foods were excluded from patient’s diet due to the clinical diagnosis of food allergy. The child was born by vaginal delivery and had obstetrical trauma. Comments: The diagnosis of Frey syndrome (auriculotemporal syndrome or gustatory sweating) was established considering the clinical characteristic of facial fl ushing triggered after ingestion of foods and the exclusion of food allergy diagnosis. The damage to the auriculotemporal nerve caused by obstetrical trauma may misdirect the regeneration of the nerve fi bers that results in facial fl ushing with gustatory stimulation. The present case points out to the importance of appropriate differential diagnosis of food allergy in order to avoid unnecessary restrictive diets. In patients with malar fl ushing in the auriculotemporal nerve pathway after food ingestion the possibility of Frey syndrome should be considered.