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Plant dermatitis

Authors: Created 1997. Updated: Hana Numan, Medical Writer, New Zealand. Copy edited by Gus Mitchell. October 2021


Plant dermatitis — codes and concepts
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What is plant dermatitis?

Plant dermatitis is an inflammation of the skin caused by topical contact with a plant or plant constituent.

Phytodermatitis is the formal medical name for plant dermatitis, and it may be an irritant contact dermatitis, allergic contact dermatitis, or phytophotodermatitis.

Contact urticaria and mechanical irritation can also be due to plants.

Common plants that cause dermatitis

Who gets plant dermatitis?

Plant dermatitis can affect anyone in contact with the specific plant component including the sap, bark, wood, leaf, stem, flower, pollen, or fruit. Exposure may be:

What causes plant dermatitis?

  • Chemical or mechanical irritant
    • Skin injury damaging the skin barrier
    • Can affect anyone with sufficient exposure
    • Chemical irritant such as seaweed toxins
    • Mechanical irritant eg, Bindii dermatitis
  • Contact allergen
    • Delayed (type 4) hypersensitivity reaction
    • Only affects someone with an immune-mediated allergy to it
    • Examples include primula, poison ivy, grevillea
  • Phytophototoxicity
    • Plant-derived phototoxin
    • Skin reaction following contact is induced by UVA in sunlight
  • Contact urticaria
    • Non-immunological, for example formic acid in stinging nettles
    • Immunological eg, latex, the sap from rubber trees

What are the clinical features of plant dermatitis? 

  • Asymmetrical
  • Patterned such as linear or spattered
  • Erythema, blistering, scaling, or cracks
  • Distribution relative to contact site:
  • Onset
    • Rapid if acute irritant, phototoxic, or contact urticaria
    • Delayed while sensitisation develops in allergic contact, then rapid on subsequent exposure
  • Symptoms
    • Burning pain with irritant or phototoxic reactions
    • Itchy if allergic contact
    • Contact urticaria may cause burning, tingling, or itch

Plant dermatitis

How do clinical features vary in differing types of skin?

What are the complications of plant dermatitis?

How is plant dermatitis diagnosed?

Plant dermatitis should be suspected clinically on history and examination. Tests may be undertaken to clarify or confirm the diagnosis.

What is the differential diagnosis for plant dermatitis?

What is the treatment for plant dermatitis?

General measures

  • Minimise contact with the relevant plant
    • Protective clothing
    • Remove the implicated plant from the garden
  • Sun protection
  • Avoid aggravating the problem with potentially irritating or allergenic topical applications
  • Cool compress

Specific measures

  • Topical or oral corticosteroids for the acute inflammatory phase
  • Chronic plant dermatitis may require systemic immunosuppressant medication

What is the outcome for plant dermatitis?

Plant dermatitis is usually self-limiting provided further contact with the implicated plant is avoided, although postinflammatory hyperpigmentation may persist for weeks or months. A true plant allergy persists lifelong.

Some forms of contact are unavoidable such as in airborne compositae allergy and a chronic photosensitive dermatitis may follow.

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Related information

 

Bibliography

  • Calapai G, Miroddi M, Minciullo PL, Caputi AP, Gangemi S, Schmidt RJ. Contact dermatitis as an adverse reaction to some topically used European herbal medicinal products - part 1: Achillea millefolium-Curcuma longa. Contact Dermatitis. 2014;71(1):1–12. doi:10.1111/cod.12222 [see also parts 2-4]. Journal
  • Esser PR, Mueller S, Martin SF. Plant allergen-induced contact dermatitis. Planta Med. 2019;85(7):528-34. doi:10.1055/a-0873-1494. Journal
  • Mark KA, Brancaccio RR, Soter NA, Cohen DE. Allergic contact and photoallergic contact dermatitis to plant and pesticide allergens. Arch Dermatol. 1999;135(1):67–70. doi:10.1001/archderm.135.1.67. Journal
  • Rozas-Muñoz E, Lepoittevin JP, Pujol RM, Giménez-Arnau A. Allergic contact dermatitis to plants: understanding the chemistry will help our diagnostic approach. Actas Dermosifiliogr. 2012;103(6):456–77. doi:10.1016/j.ad.2011.07.017. Journal
  • Rundle CW, Machler BC, Jacob SE. Pathogenesis and causations of systemic contact dermatitis. G Ital Dermatol Venereol. 2019;154(1):42–9. doi:10.23736/S0392-0488.18.06113-8. Journal
  • Sheehan MP. Plant associated irritant & allergic contact dermatitis (phytodermatitis). Dermatol Clin. 2020;38(3):389–98. doi:10.1016/j.det.2020.02.010. Journal

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