IGHE and anaphylaxis: Clinically, most sesame seed allergy present in at least 2 major forms: immediate hypersensitivity, often expressed as systemic anaphylaxis, associated with positive skin prick test and/or IgE antibody test results to sesame proteins with some cross-reactivity with other foods, and delayed hypersensitivity to lignin-like compounds in sesame oil clinically expressed as contact allergic dermatitis.