South Africa's role in medical training in Malawi.

identified that neither bread nor eggs, but a boiled, minced hake fish and carrot dish triggered his eczema. Carrots alone caused no reaction. The patient left to study overseas for 6 months. During that time he only had two further attacks: the first after eating Nile carp, to see if he still reacted to fish, and the second after eating a mixed dish containing fish ingredients, although the chef initially denied that the dish included fish. On returning to South Africa the eczema cleared completely from all over his body.A picture is worth a thousand words — his smile tells the story (Fig. 4). In addition, he was free of all other symptoms such as headaches, postnasal drip, wheezing, cough and symptoms of the irritable bowel syndrome, which he had suffered from most of his life. Initially, I suspected eggs or flour, but in my experience investigating foods as triggers in chronic illness, each individual case differs. In this case fish was the cause, despite the history.