Dermatosis due to Plant

Reynaldi Prasetya N.
Dermatosis due to Plant
Dermatosis caused by a plant or Phytodermatosis. Plant reactions can
be classified into urticaria (immunologic and toxin-mediated), irritant
dermatitis (mechanical and chemical), phototoxic dermatitis
(phytophotodermatitis), and allergic contact dermatitis.

Source : Bolognia, Jean, et al. Dermatology. Vol. 3, Elsevier Saunders,

2014.
in reactions caused by contact with plants will be divided in the following
manner:
• Dermatitis by Physical Trauma
• Dermatitis by Pharmacological Action
• IgE-mediated Dermatitis
• Dermatitis by Irritation
• Sunlight-induced Dermatitis
• Dermatitis by Sensitization

Source : http://www.scielo.br/scielo.php?pid=s0365-05962010000400009&script=sci_arttext&tlng=en
Immunologic Contact Urticaria
• Atopic patients
• Frequent contact with fresh fruits ad vegetables
• May present as urticaria, pruritus, burning or chronic dermatitis
• Oral allergy syndrome is mucosal contact urticaria to antigents similar
to allergenic pollen
• Protein contact dermatitis represents an eczematous eruption arising
from repeated urticarial reactions
Immunologic Contact Urticaria
The IgE-mediated release of vasoactive mediators from mast cells leads
to local urticaria. The main factor seems to be histamine, but
prostaglandins, kinins and leukotrienes probably augment the
inflammatory response
Contact Urticaria Syndrome
Toxin-Mediated (Non-Immunologic) Contact
Urticaria
• Anyone can be affected
• Stinging nettles (urtica spp.) are most common cause
• Plants contain histamine, serotonin and acetylcholine within sharp
hairs
Toxin-Mediated (Non-Immunologic) Contact
Urticaria
The leaves and stems of these plants have in their surface small needle-
like urticating hairs whose distal silicone extremity breaks after
superficially penetrating the skin. When they break, they release their
contents, composed by hystamine, serotonine, acetilcoline and other
vasoactive substances, in the dermis.
 Urtica dioica

Urtica urens

Urticating hair
Mechanical Irritant Dermatitis
• Large spines and thorns cause penetrating injuries and secondary
infection
• Smaller emergences (glochids) act like small fishhooks and embed in
skin
• Prickly pears are a cause of glochid dermatitis
• Can affect anyone
 Rose bushes
Echinocereus Family
Opuntia Family
Chemical Irritant Dermatitis
• Calcium oxalate in daffodils is a major cause of plant-related irritant
dermatitis in florists and holticulturalists
• Spurges (including poinsettias) contain irritant phorbol esters in latex
• Capsaicin in hot peppers affect cutaneous nerves, but not the skin
Chemical Irritant Dermatitis
It occurs with any individual with no need for predisposition. Direct
contact with specific plants or even maceration of plants that release
irritating or caustic substances is enough to cause dermatitis. The
degree of irritation depends on the substance, but the intensity of the
irritation depends upon the thickness of the skin, especially of the
corneal layer. Climatic factors that facilitate or reduce the penetration
of substances in the skin also play a role.
Phytophotodermatitis
• Non-Immunologic – it can be happen to anyone
• Need UVA light plus topical or oral contact with photosensitizer
• Furocoumarins (psoralens and angelicins) are most common agents
• Limes, celery and rue ar most common causes
• Potential photosensitizing plants of the family Apiaceae can be
identified by umbel flower structure
Phytophotodermatitis
The first phase of phytophotodermatitis is an acute, oxygen-dependent
skin injury. By electronic microscopy, cytoplasmic vacuoliaztion and
membrane rupture of keratinocytes are observed immediately
following UVA irradiation of psoralen-exposed skin. Within 2 hours,
desmosomal plaques have detached and degenerated. It is known that
UVA has the ability to excite psoralens to form covalent monoadducts
with pyrimidines and interstrand DNA cross-link.
Psoralen induced hyperpigmentation occurs via increased melanocyte
mitosis and dendricity, melanocyte hypertrophy, increased tyrosinase
activity, and change in the size and distribution of melanosome