Sesquiterpene lactone mix patch testing supplemented with dandelion extract in patients with allergic contact dermatitis, atopic dermatitis and non-allergic chronic inflammatory skin diseases.
We investigated the value of patch testing with dandelion (Compositae) extract in addition to sesquiterpene lactone (SL) mix in selected patients. After we detected a case of contact erythema multiforme after patch testing with dandelion and common chickweed (Caryophyllaceae), additional testing with common chickweed extract was performed. A total of 235 adults with a mean age of 52.3 years were tested. There were 66 men and 169 women: 53 consecutive patients with allergic contact dermatitis (ACD); 43 with atopic dermatitis (AD); 90 non-atopics suffering from non-allergic chronic inflammatory skin diseases; 49 healthy volunteers. All were tested with SL mix 0.1% petrolatum (pet.) and diethyl ether extracts from Taraxacum officinale (dandelion) 0.1 and 3.0% pet. and from Stellaria media (common chickweed) 0.1 and 3% pet. A total of 14 individuals (5.9%) showed allergic reaction (AR) to at least 1 of the plant allergens, 4 (28.6%) to common chickweed extract, and 11 (78.6%) to Compositae allergens. These 11 persons made the overall prevalence of 4.7%: 8 (3.4%) were SL-positive and 3 (1.3%) reacted to dandelion extract. 5 persons (45.5%) had AD, 2 had ACD, 2 had psoriasis and 2 were healthy controls. The Compositae allergy was relevant in 8 cases (72.7%). The highest frequency of SL mix sensitivity (9.3%) was among those with AD. Half the SL mix-sensitive individuals had AD. ARs to dandelion extract were obtained only among patients with eczema. A total of 9 irritant reactions (IRs) in 9 individuals (3.8%) were recorded, 8 to SL mix and 1 to common chickweed extract 3.0% pet. No IR was recorded to dandelion extract (P = 0.007). Among those with relevant Compositae allergy, 50.0% had AR to fragrance mix and balsam of Peru (Myroxylon pereirae resin) and colophonium. SLs were detected in dandelion but not in common chickweed. Our study confirmed the importance of 1 positive reaction for emerging, not fully established, Compositae allergy. In conclusion, the overall prevalence of 4.7% in our study represents a basal SL mix detection rate of 3.4% reinforced and safely supplemented by testing with the dandelion extract.
Medical Faculty of Novi Sad, Clinic for Dermatovenerologic Diseases, Clinical Center, University of Novi Sad, Serbia and Montenegro. brkics@uns.ns.ac.yu
M
M
Jovanović
M
M
Poljacki
N
N
Mimica-Dukić
P
P
Boza
Lj
Lj
Vujanović
V
V
Duran
S
S
Stojanović
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000276:immunology; D003876:Dermatitis, Atopic / Q000276:immunology; D017453:Dermatitis, Irritant / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation; D007509:Irritants / Q000008:administration & dosage / Q000276:immunology*; D007783:Lactones / Q000008:administration & dosage / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods*; D010936:Plant Extracts / Q000276:immunology; D011237:Predictive Value of Tests; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000276:immunology*; D012871:Skin Diseases / Q000276:immunology*; D029752:Stellaria / Q000276:immunology; D031205:Taraxacum / Q000276:immunology*; D013997:Time Factors
D000485:Allergens; D007509:Irritants; D007783:Lactones; D010936:Plant Extracts; D012717:Sesquiterpenes