{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:24:31Z","timestamp":1774355071528,"version":"3.50.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Allergy Asthma Clin Immunol"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Frey\u2019s syndrome (auriculotemporal syndrome) is characterized by gustatory flushing and sweating in the distribution of the auriculotemporal nerve. Although classically described after parotid surgery in adults, congenital and idiopathic forms are increasingly recognized in infants. Because symptoms occur during feeding, the condition can closely mimic IgE-mediated food allergy, leading to unnecessary dietary restrictions and anxiety.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n We report an 8-month-old boy referred for evaluation of suspected multiple food allergies after several emergency department visits for feeding-associated facial redness, interpreted by caregivers as \u201chives\u201d, and accompanied by significant parental anxiety and progressive dietary avoidance. On detailed reassessment, reactions were found to consist of localized, unilateral flushing and sweating of the right cheek, without urticaria or systemic features. Skin prick testing and serum-specific IgE testing to common food allergens were negative. During a supervised baked milk oral food challenge, a similar unilateral cutaneous reaction was observed, confirming the diagnosis of Frey\u2019s syndrome. A home-recorded video demonstrated comparable findings during feeding with formula.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Frey\u2019s syndrome is an important and under-recognized mimic of food allergy in infancy. Careful attention to laterality, absence of systemic involvement, and reproducibility across foods can prevent misdiagnosis, reduce unnecessary dietary restriction, and alleviate family anxiety.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Frey\u2019s syndrome should be considered in infants with reproducible unilateral flushing during feeding. Awareness among allergists can prevent misdiagnosis, reduce unnecessary food avoidance, and support safe nutritional and developmental outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s13223-026-01015-3","type":"journal-article","created":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T03:05:08Z","timestamp":1771124708000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frey\u2019s syndrome in an infant misdiagnosed as food allergy"],"prefix":"10.1186","volume":"22","author":[{"given":"Melanie","family":"Semaan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheikha","family":"Alkhuder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samira","family":"Jeimy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"issue":"9","key":"1015_CR1","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1001\/archderm.1997.03890450093011","volume":"133","author":"MV Dizon","year":"1997","unstructured":"Dizon MV, Fischer G, Jopp-McKay A, Treadwell PW, Paller AS. Localized facial Flushing in infancy: auriculotemporal nerve (Frey) syndrome. Arch Dermatol. 1997;133(9):1143\u20135.","journal-title":"Arch Dermatol"},{"issue":"3","key":"1015_CR2","first-page":"e137","volume":"59","author":"L Caulley","year":"2013","unstructured":"Caulley L, Al-Hussaini A, Manoukian J. Pediatric auriculotemporal nerve (Frey) syndrome. Can Fam Physician. 2013;59(3):e137\u20139.","journal-title":"Can Fam Physician"},{"issue":"6","key":"1015_CR3","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1016\/j.ijporl.2015.03.023","volume":"79","author":"BN Tillman","year":"2015","unstructured":"Tillman BN, Lesperance MM, Brinkmeier JV. Infantile frey\u2019s syndrome. Int J Pediatr Otorhinolaryngol. 2015;79(6):929\u201331.","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"1015_CR4","first-page":"9285496","volume":"2016","author":"S Hassan","year":"2016","unstructured":"Hassan S, Al-Abbad A, Al-Ali A. Recurring facial erythema in an infant: frey\u2019s syndrome revisited. Case Rep Pediatr. 2016;2016:9285496.","journal-title":"Case Rep Pediatr"},{"issue":"12","key":"1015_CR5","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1111\/jpc.15771","volume":"57","author":"I Els","year":"2021","unstructured":"Els I, Delanty J. Infantile Frey syndrome. J Paediatr Child Health. 2021;57(12):2040\u20131.","journal-title":"J Paediatr Child Health"},{"issue":"10","key":"1015_CR6","first-page":"3697","volume":"181","author":"C Betti","year":"2022","unstructured":"Betti C, Boneschi V, Fanoni D, et al. Auriculotemporal (Frey) syndrome not associated with surgery or diabetes: a systematic review. Eur J Pediatr. 2022;181(10):3697\u2013710.","journal-title":"Eur J Pediatr"}],"container-title":["Allergy, Asthma & Clinical Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13223-026-01015-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13223-026-01015-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13223-026-01015-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:14:35Z","timestamp":1774350875000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13223-026-01015-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,15]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1015"],"URL":"https:\/\/doi.org\/10.1186\/s13223-026-01015-3","relation":{},"ISSN":["1710-1492"],"issn-type":[{"value":"1710-1492","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,15]]},"assertion":[{"value":"22 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of clinical details and images was obtained from the patient\u2019s legal guardian.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12"}}