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ORIGINAL CONTRIBUTIONS
Year : 1990  |  Volume : 56  |  Issue : 1  |  Page : 27-30

Contact dermatitis from compositae plants




Correspondence Address:
S C Sharma


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  Abstract 

Eighty patients (58 males and 22 females) suspected of compositae contact dermatitis and 22 controls were investigated using ethanolic plants extracts., Fifty four (68%) patients and none of the controls had positive patch tests. Forty five (56%) of these patients showed positive reactions with, extracts of only a single Compositae plant. Parthenium hysterophorus produced positive reactions in 51%, Chrysanthemum morifolium in 23%, Dahlia pinnata in 9% and Tagetes indica in 4% patients. The highest number (84%) of patients with positive patch tests were exposed to these plants during their occupation.


Keywords: Compositae, Contact dermatitis, Parthenium hysterophorus , Chrysanthemum morifolium, Dahlia pinnata, Tagetes indica.


How to cite this article:
Sharma S C, Kaur S. Contact dermatitis from compositae plants. Indian J Dermatol Venereol Leprol 1990;56:27-30

How to cite this URL:
Sharma S C, Kaur S. Contact dermatitis from compositae plants. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2019 Dec 15];56:27-30. Available from: http://www.ijdvl.com/text.asp?1990/56/1/27/3474


Compositae plants are one of the commonest causes of plant dermatitis with over 150 species identified for their allergenicity.[1],[2] The sensitis­ing capacity of these plants is relatively high and it occurs most commonly in those who are in close and frequent contact with them like the gardeners, farmers, florists and labourers.[2],[3],[4],[5] Contact dermatitis due to Compositae plants has been reported from all parts of the world, though more commonly from countries with a warmer climate.[1],[2],[4],[5],[6],[7],[8],[9],[10] Due to a wide geogra­ phical variation, different genera of the Com­positae family constitute common sensitizers in different regions of the world like ragweeds in the American subcontinent, chrysanthemums in Europe and capeweed in Australia.[1],[2],[6],[7] From India, Parthenium hysterophorus has been reported to be the main cause of Compositae contact dermatitis though many other Com­positae plants are widely prevalent and have also been reported to cause contact sensitization.[4],[5],[10] We report our findings on the contact dermatitis from the four Compositae plants prevalent in north India.


  Materials and Methods Top


Eighty patients (58 males and 22 females) with contact dermatitis suspected to be due to Compositae plants attending the contact derma­titis clinic constituted the study group. Twenty two (16 males and 6 females) age matched subjects with history of exposure to Compositae plants but without any signs or symptoms of contact dermatitis constituted the control group. Three species of flowering Compositae plants prevalent in this region and grown at the Insti­tute's nursery namely Chrysanthemum morifolium (chrysanthemums), Dahlia pinnata (dahlia) and Tagetes indica (marigold) along with the wild growing weed Parthenium hysterophorus (carrot weed) were taken up for the study. The plant extracts were prepared by the method as re­commended by Hollister-Stier, USA with slight modifications and described in detail pre­viously.[11],[12] In brief, about 50 mature flowering plants of each of the 4 Compositae species were collected and cut into small pieces. Half of the plants of each species were air-dried as whole plants and half as flowers, leaves and stems separately. The air-dried plant materials were then steeped in diethyl ether (approximately 500 ml of ether for each 50 gm dried plant material) in sealed glass containers for 24 hours. This ether extract was then filtered through 4 layers of cotton-gauze. From the extract thus obtained, ether was evaporated using a rotary evaporator till approximately 5 ml of the resinous extract remained (the stock solution). Dilutions from this stock solution were then freshly prepared in ethanol every 3 months and stored in screw-capped amber coloured bottles at 4 osub C.

Patch tests were carried out with the extracts of the whole plant, the flowers, the leaves and the steins with 1 : 100 and 1 : 200 dilutions in case of Parthenium hysteropherus and with 1 : 5 and 1 : 10 dilutions for the 3 other Compositae plants. None of the patients had active derma­titis or was receiving systemic corticosteroids at the time of patch testing. The patch tests were applied on the upper back using 35 ul of the extract and the Finn chamber technique.[13] Readings were done at 48 hours and 72 hours and graded from 1+ to 3+ as recommended by the International Contact Dermatitis Research Group.


  Results Top


Majority (68%) of the patients and the controls were in the age group between 20-40 years. The mean age was 40.1 and 39.8 years in the patients and the controls respectively. Duration of the disease ranged from 2 months to 10 years (average 42 months). Thirty two (40%) patients were exposed to Compositae plants during their occupational work as garde­ners (18), farmers(6), labourers(5) and florists (3), 35 (44%) got exposed during their hobby of gardening, and 13 (16%) patients including office workers (6), factory workers (5), surveyors (1) and housewives (1) gave no history of direct exposure to the plants though they were aware of the Compositae plants in their environment and thought these to be the cause of their der­matitis [Table - 1]. Fifty six per cent patients complained of photoaggravation during the months of March to August, and 51 % of the patients gave a history of aggravation of their rash in the spring, summer and early winter seasons when the winds and dried plant materials lead to increased exposure to these plants.

Fifty four (68%) patients had positive patch tests, 45 (56%) of them showing positive tests with extracts of only one of the plants studied. Positive reactions were obtained with Parthenium hysterophorus in 32 (40%), chrysanthemums in 9 (11 %), dahlia in 3 (4%,) and marigold in 1 (1%). In the remaining 9 patients positive reactions were seen with the extracts of more than one plant. Males demonstrated more frequent( 73%) positive reactions than females (55%). Patients exposed during their occupation had a signi­ficantly higher number (84%) of positive patch tests when compared to those exposed to these plants during their hobby or indirectly.

The clinical pattern of dermatitis was, (1) airborne involving upper eyelids, face, retro­auricular area and antecubital fossae in 40 patients and 85% of them had positive patch tests; (2) involving only the hands and face in 18 patients with 61 % showing positive patch tests, and (3) involving photoexposed parts of face, neck, arms and hands in 10 patients with 50% positive patch tests [Table - 2]. The highest number (5 i %) of positive patch tests were seen with Parthen urn hysterophorus and the lowest (4%) with marigold [Table - 2].


  Comments Top


The allergens of the Compositae plants are mostly present in the oleoresins on the surface of the floweis, the leaves and the steins. The commonest allergenic compounds of the Com­positae plants are sesquiterpene lactones and more than 210 of them have already been isolated and identified.[3],[4],[15] Each species has been demonstrated to produce its own selection of lactones providing it with specific allergenicity.[3] Demonstration of positive patch tests with extracts of only one of the Compositae plants tested in 56% of the patients in this study pro­vides further evidence of this specific allergenicity of these species in spite of the reported prevalence of cross-sensitivity among the members of the Compositae family.[3],[14],[15],[16]

The contact sensitivity to Compositae plants has been recorded more often in those coming in close and frequent contact with these plants[1],[2],[4],[5],[6] as was also the case in our study.

Contact dermatitis due to Compositae plants can present with various clinical patterns depend­ing upon the plant species, mode of exposure, climate and clothing habits of those exposed to these plants.[1],[2],4],[6] The commonest clinical presentations in our study were airborne contact dermatitis pattern and hands and face dermatitis pattern.

Thus, in this region of north India, though Parthenium hysteronhorars is still the commonest cause of contact dermatitis, yet other Compositae species such as chrysanthemums and less commonly the dahlia and the marigold may also account for some cases of contact sensitivity to Compositae plants as has already been reported by other workers.[4],[5]

 
  References Top

1.Stoner JG and Rasmussen JE : Plant dermatitis, J Amer Acad Dermatol, 1983; 9 : 1-15.  Back to cited text no. 1    
2.Mitchell JC and Rook A : Botanical Dermatology. Plants and Plant Products Injurious to the Skin, Greengrass, Vancouver, 1979; p 1-39.  Back to cited text no. 2    
3.Hausen BM : The sensitizing capacity of Com­positae plants. III. Test results and cross reactions in Compositae sensitive patients, Dermatologica. 1979; 159 : 1-11.  Back to cited text no. 3    
4.Lonkar A, Mitchell JC and Calnan CD : Allergic contact dermatitis from Porthenimn hvsteronhort's. Trans St John Hosp Dermatol Soc, 1974; 60 43-53.  Back to cited text no. 4    
5.Pasricha JS : Contact Dermatitis in India, 2nd edition, Department of Science and Technology, Government of India, New Delhi, 1987; p 25-39.  Back to cited text no. 5    
6.Shelmire B : Contact dermatitis from weeds Patch testing with their oleoresins, JAMA, 1939; 113 : 1085-1090.  Back to cited text no. 6    
7.Burry JN, Kuchel R, Reid JG et al : Australian bush dermatitis : Compositae dermatitis in south Australia, Med J Austral, 1973; 1 : 110-116.  Back to cited text no. 7    
8.Mitchell JC, Geissman TA, Dupuis G et al Allergic contact dermatitis caused by Artemisia and Chrysanthemum species, J Invest Dermatol, 1971 ; 56 : 98-101.  Back to cited text no. 8    
9.Menz J and Winkelman RK : Sensitivity to wild vegetation, Contact Dermatitis, 1987; 16 : 169-173.  Back to cited text no. 9    
10.Tiwari VD, Sohi AS and Chopra TR : Allergic contact dermatitis due to Parthenium hpstero­phorus, Ind J Dermatol Venereol Leprol, 1979; 45 : 392-400.  Back to cited text no. 10    
11.Sharma SC : A study of factors involved in the photosensitivity dermatitis and the use of photo­ therapy in the treatment of photosensitivity, Thesis for Master of Medical Sciences, University of Dundee, UK, 1983; 101-105.  Back to cited text no. 11    
12.Addo A, Sharma SC, Ferguson J et al : A study of Compositae plant extract reactions in photosensiti­vity dermatitis, Photodermatology, 1985; 2 : 68-79.  Back to cited text no. 12    
13.Kaur S and Sharma VK : Indigenous patch test unit resembling Finn-chamber, Ind J Dermatol Venereol Leprol, 1986; 52 : 332-336.  Back to cited text no. 13    
14.Hjorth N, Roed-Petersen J and Thomsen K Airborne contact dermatitis from Compositae oleoresins simulating photodermatitis, Brit J Dermatol, 1976; 95 : 613-619.  Back to cited text no. 14    
15.Mitchell JC : Biochemical basis of geographical ecology. Part 2, Internat J Dermatol, 1975; 14 301-320.  Back to cited text no. 15    
16.Stampf JL, Schlewer G, Ducombs G et al : Allergic contact dermatitis to sesquiterpene lactones, Brit J Dermatol, 1978; 99: 163-169.  Back to cited text no. 16    


    Tables

[Table - 1], [Table - 2]

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