title: [Irritant contact dermatitis caused by direct contact with oleander (Nerium oleander)].
abstract: BACKGROUND
  Although the oleander plant is practically ubiquitous throughout the Mediterranean area, very few publications refer to its cutaneous toxicity.
  
  
  METHODS
  Herein, we report two cases of irritant contact dermatitis caused by oleander. The patients in question were twins who had oleander leaves applied directly to their face for 20minutes. The initial lesions consisted of periorbital erythema, followed by the emergence of papules and macules. Vesicles and crusts appeared over the ensuing 24hours. Treatment included withdrawal of the toxic agent, prescription of oral antihistamines, and the topical application of dermocorticoids to the lesions for two weeks. The outcome on the 9th day was slightly hypochromic and atrophic. Complete restitutio ad integrum of the skin was observed after 30 days.
  
  
  CONCLUSIONS
  In our patients, a joint effect of ultraviolet radiation (phytophotodermatitis) and chlorine from the swimming pool cannot be ruled out. Although the substances present in oleanders (irritant saponins and glycosides) can cause chemical irritant dermatitis, immunological reactions cannot be excluded. The lack of signs of systemic toxicity observed is the result of the factors governing transdermal diffusion of the toxic glycosides found in oleander.
  
  
  CONCLUSIONS
  These two cases provide a timely reminder, both for the general public and for healthcare professionals, of the potential biohazards of oleander, not only because of its systemic toxicity but also because of the risks associated with cutaneous exposure.
authors.affiliation: Centre antipoison et de toxicovigilance d'Aquitaine et de Poitou-Charente, CHU Pellegrin Tripode, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Pellet
authors.affiliation: Centre antipoison et de toxicovigilance d'Aquitaine et de Poitou-Charente, CHU Pellegrin Tripode, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Masson-Regnault
authors.affiliation: Service de dermatologie, hôpital Haut-Lévêque, université de Bordeaux, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Beylot-Barry
authors.affiliation: Centre antipoison et de toxicovigilance d'Aquitaine et de Poitou-Charente, CHU Pellegrin Tripode, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: magali.labadie@chu-bordeaux.fr.
authors.forename: M
authors.initials: M
authors.lastname: Labadie
mesh_terms: D000293:Adolescent; D001768:Blister / Q000209:etiology; D003877:Dermatitis, Contact / Q000209:etiology*; D004200:Diseases in Twins / Q000209:etiology*; D005148:Facial Dermatoses / Q000209:etiology*; D005260:Female; D006027:Glycosides / Q000493:pharmacokinetics / Q000633:toxicity; D054879:Halogenation; D006801:Humans; D007509:Irritants / Q000633:toxicity*; D008297:Male; D030007:Nerium / Q000633:toxicity*; D018515:Plant Leaves / Q000633:toxicity; D010947:Plants, Toxic / Q000633:toxicity; D012503:Saponins / Q000493:pharmacokinetics / Q000633:toxicity; D012869:Skin Absorption; D013551:Swimming Pools; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D006027:Glycosides; D007509:Irritants; D012503:Saponins
keywords: Contact dermatitis; Dermatite de contact; Dermatite irritative; Irritant contact dermatitis; Laurier rose; Nerium oleander; Oleander; Phytophotodermatitis; Phytophotodermatose