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CASE REPORT
Year : 1990  |  Volume : 56  |  Issue : 4  |  Page : 319-321

Contact dermatitis due to xanthium strumarium




Correspondence Address:
J S Pasricha


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  Abstract 

A 50-year-old mining engineer at Dhanbad was having air bome contact Dermatitis suspected to be caused by Xanthium strumarium. Patch tests with a 15% aqueous extract of air dried leaves showed a severe positive reaction, but the patient also had positive patch tests with Parthenium hysterphorus and a few other weeds and trees known to cause air-borne contact dermatitis. The titre of contact hypersensitivity with the extract of Xanthium struma'rium was more than 1:100,000 and for Parthenium hysterophrous it was 1:10 indicating a high degree of hypersensitivity to Xanthium strumarium. Further tests in 14 other patients revealed a high prevalence of cross sensitivity between these two plants both of which belong to the compositae family.


Keywords: Contact dermatitis, Xanthium strumarium


How to cite this article:
Pasricha J S, Bhaumik P, Agarwal A. Contact dermatitis due to xanthium strumarium. Indian J Dermatol Venereol Leprol 1990;56:319-21

How to cite this URL:
Pasricha J S, Bhaumik P, Agarwal A. Contact dermatitis due to xanthium strumarium. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2019 Aug 22];56:319-21. Available from: http://www.ijdvl.com/text.asp?1990/56/4/319/3559


Air borne contact dermatitis (ABCD) is the term used for patients having contact dermatitis due to the agents suspended in the air and settling on the uncovered parts of the body. The actual extent of involvement varies from patient to patient depending upon the style and the shape of the clothes worn by the patient, but the commonly involved areas include the face, neck, hands, forearms, dorsal aspects of feet, legs and thighs sparing the areas covered by the shoes and the clothes.[1] The agents commonly responsible for this type of dermatitis are either the plants whose components such as pollen, trichromes or dry leaf fragments can get air borne, or the industrial agents which pollute the air in the factory. The plant most commonly responsible for this type of dermatitis in India is Parthenium hysterophorus, but less commonly, other plants may also be responsible.[1] We have recently investigated a patient who showed a high degree of contact hypersensitivity to Xanthium strumarium.


  Case Report Top


A 50-year-old mining at Dhanbad (Bihar) was developing recurrent attacks of itching and papulo-vasicular lesions predominantly on the face, neck, hands and forearms since 1969. He would generally get aggravations during the months of May to September, while during the rest of the year he was relatively free. These episodes continued for the next 9 years. When he was transferred to another job which involved working inside an office in the same area, his disease became much milder. In 1985, he again started getting more aggravations though these were not as severe as the previous attacks. It was observed that whenever he left Dhanbad, he felt better. His visits to Goa, Shillong, Kashmir, Punjab and Delhi for periods of 10-15 days each reduced the severity of his.dermatitis. In 1987, he started the field work again developed the disease in a severe form, also involving the feet, legs, thighs and upper central part of the chest. He attributed his disease to a wild shrub growing abundantly in the area of his work. He would get relief from topical and/or systemic corticosteriods. He was diagnosed as a case of air borne contact dermatitis and patch tested with the.standard extracts' of dried leaves of Parthenium hysterophorus, Lantana camara, Calotropics procera, Nerium variabilis, Acacia indica, Eucalyptus, Cynodon dactylon, Ficus religiosa, Asadirachta indica, Dalbergia sissoo, Grevillea robusta, and Saraca indica, and also a small piece of the leaf of Xanthium strumarium which he himself suspected as the cause of his dermatitis. He developed a very severe papulo­vesicular reaction with ulceration at the site of the patch test with Xanthium strumarium in addition to the milder positive reactions with all the other plants. The reactions were controlled with systemic corticosteroids. Four weeks later, the patch tests were repeated to determine the titre of contact hypersensitivity (TCH) with Xanthium strumarium using a 15% aqueous extract of air dried leaves of Xanthium strumarium used as such and also ten-fold dilutions of this extract in distilled water to a maximum of 1 : 100,000[2]. Patch tests were positive with all the dilutions including the 1 100,000 dilution, the higher concentrations produced relatively severe reactions than the lower concentrations.. The TCH determined for Parthenium hysterophorus on a subsequent occasion was 1 : 10 and positivity with Lantana camara, Calotropis procera and Nerium variabilis was also confirmed on repeat patch tests, while tests with the other plants could not be repeated because of lack of space.


  Comments Top


Our patient was possibly a case of contact hypersensitivity to multiple plants, all of which have been recorded to cause air borne contact dermatitis.[1] Of all the plants, however, he showed the maximum contact hypersensitivity to Xanthium strumarium, the TCH being more than 1 : 100,000 compared to 1 : 10 for Parthenium hysterophorus. The earlier studies on plants causing contact dermatitis[3],[4],[5],[6],[7],[8] do not mention about Xanthium strumarium except' for a brief note by cronin[9] that Xanthium Strumarium is also an allergenic plant. The national survey for the causes of contact dermatitis has recorded 4 positive patch test reactions out of a total of 104 cases tested with this plant, and 3 of these cases had been recorded at Delhi.[1] The records reveal that all these 3 patients also had concomitant positive patch tests with Parthenium hysterophorus. We have subsequently tested 14 more patients with the standard undiluted extract of this plant and found positive patch tests in 8 of the 9 patients having air borne contact dermatitis but negative reactions in all the five patients having contact dermatitis due to other causes such as hair dyes, shoe materials, bindi and metals. Negative patch tests with the standard undiluted extract of Xanthium strumarium in all the patients having contact dermatitis due to agents other than plants confirms that this extract does not have irritant properties, but positive patch tests in all the ACBD patients and cross­sensitivity with Parthenium hysterophorus suggests that the incidence of contact hypersensitivity with this plant may be much higher than suspected so far.

Like Parthenium hysterophorus, Xanthium strumarium [Figure - 1] is also a member of then Compositae family which grows wild in wast­lands, road-sides and along the rivers almost all over the country. It is an undershrub which attains a height of 1.5 meters and has its flowering season from September to June. It has large, coarse lobed, triangular leaves with serrated edges and characteristic oblong 1.5 cm long fruit which bear soft spiny processes all over its surface. The common local names of this plant include Bhangra, Bichhu, Churchutta, Kutia, Kutta, Chitchitta, Bhurat and Bhurchitta.[10]

 
  References Top

1.Pasricha JS : Contact Dermatitis in India, Second ed, Department of Science and Technology, New Delhi, 1988.  Back to cited text no. 1    
2.Pasricha JS : Titre of contact hypersensitivity (TCH) as a means of determining the degree of hypersensitivity in contact dermatitis, Ind J Dermatol Venereal Leprol, 1986; 52 : 195-197.  Back to cited text no. 2    
3.Pasricha JS and Sethi NC : Contact Dermatitis in India, First ed, Layka Lab Publication, Bombay, 1981.  Back to cited text no. 3    
4.Bajaj AK, Govil DC and Bhargava SN : Contact dermatitis due to plants, Ind J Dermatol Venereo! Leprol, 1982; 48 : 268-270.  Back to cited text no. 4    
5.Singh KK and Singh G : Air-borne contact dermatitis in Varanasi, Ind J Dermatol Venereol Leprol, 1986; 52 : 140-142.  Back to cited text no. 5    
6.Sharma VK and Kaur S : Contact dermatitis due to plants in Chandigarh, Ind J Dermatol Venereol Leprol, 1987; 53 : 26-30.  Back to cited text no. 6    
7.Shanmugham-Pillai SM : Contact dermatitis in Trivandrum, Ind J Dermatol Venereal Leprol, 1989; 55 : 297-300.  Back to cited text no. 7    
8.Mitchell JC and Dupuis G : Allergic contact dermatitis from sesquiterpenoids of the Compositae family of plants, Brit J Dermatol, 1971; 84 : 139-150.  Back to cited text no. 8    
9.Cronin E : Contact Dermatitis, Seconded, Chruchill Livingstone, Edingburgh, 1980; p495.  Back to cited text no. 9    
10.Maheshwari JK : The Flora of Delhi, Council of Scientific and Industrial Research, New Delhi, 1963; p 196-197.  Back to cited text no. 10    


    Figures

[Figure - 1]

This article has been cited by
1 Parthenium: A wide angle view
Lakshmi, C., Srinivas, C.
Indian Journal of Dermatology, Venereology and Leprology. 2007; 73(5): 296-306
[Pubmed]



 

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