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ORIGINAL CONTRIBUTIONS
Year : 1990  |  Volume : 56  |  Issue : 2  |  Page : 112-114

Charysanthemum contact dermatitis: Clinical patterns and patch testing with ethanolic extracts




Correspondence Address:
R C Tanwar


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Source of Support: None, Conflict of Interest: None


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  Abstract 

Forty patients with suspected chrysanthemum contact dermatitis and 20 age and sex matched controls were patch tested with ethanolic extracts of Chrysanthemum morifolium. Eighteen (45%) patients demonstrated positive patch tests. Out of these 10 (56%) patients gave a history of photoaggravation and 9 (50%) of seasonal variation. Dermatitis involving hands and face only, widespread dermatitis and airborne contact dermatitis were the common clinical patterns seen. Patients with occupational exposure to chrysanthemums demonstrated the maximum positive reactions. All the 18 patients showed positive patch tests with the extracts of flowers, 17 with leaves, 16 with whole plant and only 4 with the stem.


Keywords: Contact dermatitis, Chrysanthemum morifolium, Ethanolic extracts, Patch tests


How to cite this article:
Tanwar R C, Sharma S C, Kaur S. Charysanthemum contact dermatitis: Clinical patterns and patch testing with ethanolic extracts. Indian J Dermatol Venereol Leprol 1990;56:112-4

How to cite this URL:
Tanwar R C, Sharma S C, Kaur S. Charysanthemum contact dermatitis: Clinical patterns and patch testing with ethanolic extracts. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2020 Jun 2];56:112-4. Available from: http://www.ijdvl.com/text.asp?1990/56/2/112/3495


Chrysanthemum, a genus of Compositae family of plants is grown as a decorative flowering plant throughout the world.[1] McCord et al[2] in 1921 described contact dermatitis to chrysanthemums for the first time and since then it has been reported mainly from Europe. Canada and USA.[1],[3],[5] Though chrysanthemums are prevalent in all parts of India, there are only two published reports of chrysanthemum contact dermatitis from India, a mention of 2 cases out of 37 in a survey of contact dermatitis showing positive reactions to fresh leaf and aqueous extract of leaves of Chrysanthemum indicwn[6] and a report of Chrysanthemum morifolium as one of the causes of airborne contact dermatitis due to Compositae plants.[7] We report results of our investigations on chrysanthemum contact dermatitis in this region.


  Materials and Methods Top


Forty patients, suspected of chrysanthemum contact dermatitis were taken up for this study after an informed consent. Twenty age and sex matched subjects exposed to chrysanthemums but having no evidence of contact dermatitis were included as controls.

Sixty mature chrysanthemum of florists (Chrysanthemum morifolium) of 4 different varieties as Pompon (large size), Regular ane­mone, Button and Korean single (15 plants each) grown at the Institute's nursery between October and November. 1986 were collected for preparation of plant extract. All the 60 plants were shredded into small pieces and air-dried. Thirty plants were kept as flowers, leaves and stems separately and 30 as whole plants. Etha­nolic plant extracts were prepared by a method comparable to the one recommended by Hollister Stier USA and described in detail previously.

Patch tests were done with 1 : 5 (20%) and 1 : 10 (10%) dilutions of t'he ethanolic extracts of the whole plant, the flowers, the leaves and the stems of C. morifolium and also with 1 : 200 (0.5;0) dilution of the ethanolic extracts of the flowers and th;; leaves of Parthenium hysterophoruv, another compositae plant widely prevalent in this region. Patches were put on the upper back using indiginous Finn chambers 10 and removed at 48 hours. Readings were done at 48 and 72 hours and graded from 1-h to 3+ as recommended by the International Contact Dermatitis Research Group.


  Results Top


Mean age of the patients was 44.2 years (range 22-73 years) and that of the controls was 35.5 years (range 19-58 years). Majority of the patients (23) and the controls (14) were in the age group of 21-40 years. Thirty two patients were exposed to chrysanthemums as a hobby of gardening, 6 during their occupation as gardeners and 2 patients were aware of chrysanthemums in their office but gave no history of direct handling.

A total of 26 (65%) patients gave positive patch tests with chrysanthemum extracts, 18 (45%) of them showed positive reactions with chrysanthemum extracts only and 8 (20%) of them with extracts of both chrysanthemums as well as P. hysterophorus. The patch test posi­tivity was highest (67%) in those with occupa­tional exposure and in none of the 2 patients with indirect exposure. Ten (56%) patients had noticed photoaggravation and 9 (50%) patients seasonal variation during the months of October and November, the blooming season of chrysan­themums. The clinical patterns seen were: airborne contact dermatitis, widespread dermatitis, only hands and face dermatitis and photodermatitis pattern [Table - 1].

Positive patch tests were seen with the extract of flowers in all the 18 patients, with leaves in 17 and with whole plant in 16. Stems were found to be the least allergenic with only 4 patients showing positive patch tests.


  Comments Top


Chrysanthemum contact dermatitis has been reported to affect both men and women and mainly the middle-aged persons,[3],[5],[12] as also seen in the present study.

Chrysanthemum dermatitis is more common during their blooming season as was observed in our study, though in Europe it seems to be present throughout the year[12],[14] perhaps due to their availability round the year. Association between contact hypersensitivity to chrysan­themums and photosensitivity has previously been recorded [5],[8],[9] 56% of the patients in the present study also gave a history of photoaggra­vation though no phototesting or photopatch tests were done in the present study.

The allergenic components of chrysanthe­mums, the oleoresins occur on the surface of flowers, leaves and the stems.[3],[12],[13] In the previous study by Bleumink et al[3] comparing extracts from different parts of the chrysanthe­mums, the alcoholic extracts of the flowers and leaves were found to show maximum reactivity, while extract of the stems did not show any reaction. The results of the present study with ethanolic extracts have confirmed these findings. Thus, Chrysanthemum morifolium seems to be another important compositae plant besides Parthenium hysterophorus as a cause of contact dermatitis due to compositae plants.

 
  References Top

1.Rook A : Plant dermatitis. The significance of variety-specific sensitizations, Brit J Dermatol, 1961; 73 : 283-287.  Back to cited text no. 1    
2.McCord P, Kilker CH and Minster K : Pyrethrum dermatitis. A record of the occurrence of occupa­tional dermatoses among workers in pyrethrum industry, J Amer Med Assoc, 1921; 77 : 448-553.  Back to cited text no. 2    
3.Bleumink E, Mitchell JC and Nater JP : Contact dermatitis to chrysanthemums, Arch Dermatol, 1973; 108 : 220-222.  Back to cited text no. 3    
4.Compolmi P, Sertoli A. Fabbri P et al : Alanto­lactone sensitivity in chrysanthemum contact dermatitis, Contact Dermatitis, 1978; 4 : 93-97.  Back to cited text no. 4    
5.Frain-Bell W, Hetherington A and Johnson BE Contact allergic sensitivity to chrysanthemums and the photosensitivity dermatitis and actinic reticuloid syndrome, Brit J Dermatol, 1979; 101 491-501.  Back to cited text no. 5    
6.Pasricha JS : Contact Dermatitis in India, 2nd ed, Department of Science and Technology, New Delhi, 1988; p 38.  Back to cited text no. 6    
7.Sharma SC and Kaur S : Airborne contact derma­titis from Compositae plants in northern India, Contact Dermatitis, 1989; 20 (In press).  Back to cited text no. 7    
8.Sharma SC A study of factors involved in the photosensitivity dermatitis and the use of phototherapy in the treatment of photosensitivity, Master of Medical Science thesis of the Dundee University, Dundee, UK, 1983; p 101-105.  Back to cited text no. 8    
9.Addo HA, Sharma SC, Ferguson J et al : A study of Cmnpositae plant extract reactions in photosensitivity dermatitis, Photodermatology, 1985; 2 : 68-79.  Back to cited text no. 9    
10.Kaur S and Sharma VK : Indigenous patch test unit resembling Finn-Chamber, Ind 7 Dermatol Venereol Leprol, 1986; 52 : 332-336.  Back to cited text no. 10    
11.Hausen BM and Schulz KH : Chrysanthemum allergy. 111, Identification of allergens, Arch Dermatol Res, 1976; 255 : 111-121.  Back to cited text no. 11    
12.Bleumink E, Mitchell JC, Geissman TA et al Contact hypersensitivity to sesquiterpene lactones in Chrysanthemmn dermatitis, Contact Dermatitis, 1976; 2 : 81-88.  Back to cited text no. 12    
13.Mitchell JC, Dupuis G and Towers GHN : Allergic contact dermatitis from pyrethrum (Chrysanthe­rnaam spp). The roles of pyrethrosin, a sesquiter­pene lactone and pyrethrin II, Brit J Dermatol, 1972; 86 568-572.  Back to cited text no. 13    
14.Cronin E : Contact Dermatitis, Churchill Living­stone, London, 1980; p 504-505.  Back to cited text no. 14    


    Tables

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