IGHE and allergic disease: True immunoglobulin E (IgE)-mediated cocoa allergy is rare, with only a few confirmed cases published to date.<h4>Case presentation</h4>We describe the case of a 2-year-old female with a history of allergic rhinitis and anaphylaxis to tree nuts, who experienced recurrent episodes of perioral erythema and angioedema following chocolate ingestion.