Alpha-Gal Syndrome for the Dermatologist

Alpha-gal syndrome (AGS) is an allergic reaction to the carbohydrate galactose-α-1,3-galactose (alpha-gal), found in non-primate mammalian proteins, and is linked to the Lone Star tick. Since its identification in 2009, over 34,000 cases have been reported in the U.S. by 2018. AGS symptoms, which include gastrointestinal issues, urticaria, angioedema, and anaphylaxis, occur 3-6 hours after consuming mammalian meat. The Lone Star tick's range is expanding due to climate change, increasing AGS cases. Dermatologists should consider AGS in patients with chronic skin issues like urticaria or angioedema when other causes are not identified. The non-specific symptoms of AGS can lead to misdiagnosis, highlighting the need for further research on its dermatologic manifestations.