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Case reports are described of individuals who developed acute contact dermatitis after contact with the resin from the Rhus verniciflua (Toxidendron vernicifluum). Potential problems from possible extensive urban planting of this species are discussed.
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BACKGROUND: All allergic contact dermatitis caused by Philodendron species is common in the Hawaiian islands, and Toxicodendron species are the most common causes of plant-induced allergic contact dermatitis in North America. OBJECTIVE: The purpose of this study was to determine the incidence of cross-sensitivity between these plant species. METHODS: Alkylresorcinols (pentadec[en]yl and heptadec[en]ylresorcinols) were isolated and purified from extracts of Hawaiian-grown Philodendron scandens subspecies scandens and Philodendron lacerum. Alkylcatechols (mixtures of pentadec[en]ylcatechols from an extract of Toxicodendron radicans (poison ivy) were obtained from the Division of Biologics Standards (National Institutes of Health, Bethesda, MD). Seventeen patients from Hawaii and 8 patients from northern California were skin tested with 5 microL (concentrations, 1 to .001 mg/mL) of each allergen applied to the flexor forearm. The test sites remained open and were graded at 72, 96, and 144 hours. All 8 patients from California were naive to Philodendron species, and 8 patients from Hawaii were naive to Toxicodendron species. RESULTS: No cross-reactivity occurred in patients who were Philodendron sensitive and Toxicodendron naive when tested to the homologous Toxicodendron catechols. Conversely, with one exception, no cross-reactivity occurred in patients who were Toxicodendron sensitive and Philodendron naive when tested to homologous Philodendron naive when tested to homologous Philodendron resorcinols. CONCLUSION: Patients who are sensitive to Philodendron species (or other resorcinol-containing plants) may not necessarily be cross-sensitive to Toxicodendron species and vice versa.
BACKGROUND: Contact dermatitis is a common clinical problem, with prevalent sensitizers being cosmetics, metals, medicines, and plants. Plants of the Toxicodendron species cause allergic contact dermatitis (ACD) in 50% to 70% of the population. Pimecrolimus is an ascomycin macrolactam developed for the treatment of inflammatory skin diseases and approved by the US Food and Drug Administration for atopic dermatitis. There are studies supporting the effectiveness of macrolactams when administered before antigen challenge, but there are no studies describing the effectiveness of these drugs in the treatment of established human ACD. OBJECTIVE: To investigate the effect of topical pimecrolimus in the treatment of Toxicodendron-induced ACD once rash is evident. METHODS: Poison ivy tincture was applied to the bilateral anterior forearms of 12 subjects with Finn Chambers (Allerderm Diagnostic Products, Petaluma, CA). After dermatitis was evident, volunteers treated each arm twice daily with either 1% topical pimecrolimus cream or placebo in a blinded fashion. Outcomes measured were a dermatitis grading score and time to rash and itch resolution. RESULTS: The median +/- SEM time for rash resolution was 16.55 +/- 1.59 days in the treatment group and 16.27 +/- 1.82 days in the placebo group (P = 0.601). The median time for itch resolution was 4.73 +/- 1.56 days in the treatment group and 4.91 +/- 1.59 days in the placebo group (P = 0.167). The average dermatitis score was 2.26 +/- 0.17 in the treatment group and 2.32 +/- 0.15 in the placebo group (P = 0.62). CONCLUSIONS: The application of topical pimecrolimus is ineffective in the treatment of ongoing Toxicodendron-induced ACD.
A limiting dilution assay was developed to quantitate urushiol (the antigen of poison ivy; Toxicodendron radicans) specific T cells from peripheral blood of a patient with a history of rhus (poison ivy) dermatitis. It was found that maximal sensitivity with minimal nonspecific proliferation could be produced with the use of 5 U/ml of recombinant IL2 added to the assay on day 6. This donor was found to have a frequency of urushiol specific peripheral blood T cells of (1/2935). Five interleukin 2 (IL2) dependent urushiol specific T-cell clones were generated from the peripheral blood of this patient. These T-cell clones had a CD8+ (T8+) phenotype and proliferated specifically to both extracts of Toxicodendron radicans (poison ivy) leaves and pure urushiol. Pentadecylcatechol was an inferior antigen, only stimulating proliferation of one clone. The ability of all clones to proliferate to pure urushiol, despite their having been induced with leaf extract, suggests that urushiol, or closely related catechols, represent the only allergenic constituents of Toxicodendron radicans. Lymphokine production in response to antigen varied between (0.6-5.0) units/ml of interleukin 2 (IL2) and (1.0-120) units/ml of gamma interferon. Although none of the clones showed significant cytotoxicity against NK targets, three of five lines showed considerable cytotoxicity against concanavalin A treated (lectin approximated) targets. However, cytotoxicity for rhus conjugated autologous targets was not detected. It was found that several of these CD8+ clones could suppress IgG production in the presence of rhus antigen. The isolation of these T-cells from peripheral blood several months after rhus dermatitis suggests that these clones may have a role in down regulating delayed hypersensitivity to urushiol.
Systemic contact dermatitis may occur in contact-sensitized individuals when they are exposed to haptens orally, transcutaneously, intravenously or by inhalation. We report the case of a woman developing a diffuse skin eruption after the topical use of Rhus toxicodendron alcoholic extract and the oral introduction of a homeopathic preparation of the same substance for herpes treatment. An open test, performed with the Rhus toxicodendron tincture, showed an erythemato-oedematous response at 48 h and vesicular reaction at 96 h that was still present after 7 days. Patch test with 65% ethyl alcohol gave negative results. The open test performed, as control, in eight healthy informed subjects revealed negative responses to Rhus tincture application. The result is interesting because in Italy, allergic contact dermatitis to Rhus is uncommon and this case increases the understanding of the pathogenetic mechanism leading to systemic contact dermatitis development.
Grevillea 'Robyn Gordon' is an Australian hybrid plant which may cause allergic contact dermatitis. Over the past 8 years, it has been planted extensively in Australia and is now being exported to the United States and other Western countries. Recently, an explosion in incidence of contact dermatitis due to this plant has been seen. 24 patients who were suspected of being sensitive to it were patch tested to fresh plant and extracts with confirmation of sensitivity. A cross sensitivity to Toxicodendron was demonstrated clinically and on patch testing. The allergen in Toxicodendron, 3 pentadecylcatechol, is closely linked in chemical structure to 5-pentadecylresorcinol, present in Grevillea banksii and tridecylresorcinol in Grevillea robusta. Patch testing in patients sensitive to Grevillea 'Robyn Gordon' with tridecylresorcinol produced positive reactions, thus implicating the sensitizing rôle of long chain alkyl resorcinols in Grevillea 'Robyn Gordon' allergy. There is a likelihood that this sensitizing potential extends to other plants of the Grevillea genus, e.g., Grevillea robusta. With the spread of Grevillea 'Robyn Gordon' to other markets, this problem will become increasingly common.
Procedures are described that were used in the isolation and characterization of urushiol components reported to be the allergenic constituents of poison oak, Toxicodendron diversilobum. Characterization of these components by spectral techniques indicated they are unsaturated congeners of 3-heptadecylcatechol, possessing one, two, or three double bonds in an unbranched C17 side chain. These components are shown to differ from those isolated from poison ivy, Toxicodendron radicans, by a - CH2CH2-unit in the unbranched alkyl side chain.
OBJECTIVE: In order to elucidate potential anti-inflammatory activities of Zeel comp. N and its constituents, the inhibition of the synthesis of Leukotriene B4 (LTB4) and Prostaglandin (PGE2) by 5-lipoxygenase (5-LOX) and cyclo-oxygenase 1 and 2 (COX 1 and 2) respectively were examined in vitro. MATERIALS: Human HL-60 cells, differentiated for 6-8 days with DMSO (1.2% v/v) were used for the 5-LOX assay. The COX activity assays were carried out with purified enzymes, COX 1 (ram seminal vesicles), COX 2 (sheep placenta) and with human THP-1 cells, differentiated for 24 h with PMA (50 nM). METHODS: LTB4 and PGE2 production in the 5-LOX and COX assays respectively were determined by enzyme linked immunoassays. RESULTS: A reconstituted Zeel comp. N combination as well as its constituent mother tinctures of Arnica montana, Sanguinaria canadensis and Rhus toxicodendron (Toxicodendron quercifolium) showed distinct inhibitory effects on the production of LTB4 by 5-LOX (IC50 values of 10, 20, 2 and 5 microg/ml respectively) and on the synthesis of PGE2 by COX 1 (IC50 values of 50, 80, 40 and 20 microg/ml respectively) and COX 2 enzymes (IC50 values of 60, 110, 50 and 20 microg/ml respectively). The mother tincture of Solanum dulcamara inhibited the production of PGE2 by COX 1 (IC50 40 microg/ml) and COX 2 (IC50 150 microg/ml) but not production of leukotriene LTB4 by 5-LOX. CONCLUSIONS: The observed dual inhibition of both LOX- and COX-metabolic pathways may offer an explanation for the reported clinical efficacy and the favorable gastrointestinal tolerability of the original remedy Zeel comp. N.
The arbor stratum of Quercus aliena var. acuteserrata stands included two substratums. Phanerophyta synusium was in first position, and hemicryptophyta was inferior to it. The DBH structures of Quercus aliena var. acuteserrata and Pinus armandii were sinister normal school, which could finish self-regeneration under the natural conditions. The small DBH class individuals of Pinus tabulaeformis were dominant, their DBH classes being distributed irregularly and absent very much. The large DBH classes of Toxicodendron vernicifluum took biggish proportion, belonging to declining population. Young trees were the principal individuals of Castanea mollissima, and in transitional age stage from the young to the middle. Populus davidiana was in the transitional stage from progressive to stable and young-middle age stands. The stands DBH structure was mainly influenced by the DBH variety of Quercus aliena var. acuteserrata population. Quantitative classification (ward's method ward) and ordination (PCA) were used to study the community types of sharp-tooth oak. The results showed that the community could be divided into 6 types: 1. Ass. Smilax stans + Rosa multiflora-Quercus variabilis + Ulmus glaucescens-Quercus aliena var. acuteserrata; 2. Ass. Smilax stans + Lespedeza bicolor-Castanea mollissima-Q. aliena var. acuteserrata; 3. Ass. Corylus mandshurica-Populus davidiana + Dendrobenthamia angustata-Q. aliena var. acuteserrata; 4. Ass. Prunus pseudoccrasus + Corylus mandshurica-Toxicodendron vernicifluum-Q. aliena var. acuteserrata; 5. Ass. Corylus mandshurica + Rosa multiflora-Pinus armandii-Q. aliena var. acuteserrata; and 6. Ass. Sinarundinaria nitida-Pinus armandii + Pinus tabulaeformis-Q. aliena var. acuteserrata. Ward's method ward was better for classifying community types than the other clustering analyses in Qinling Mountains. The PCA results were consistent with the clustering, and demonstrated that the sharp-tooth oak stands were influenced by the altitude, site gradient and soil mainly.
A black spot in the epidermis over a blister of poison ivy dermatitis is an uncommon finding. Four patients with the phenomenon are described. Histologic and histochemical studies were made on biopsy material and the blackish deposit on the skin surface was compared with black deposits in and on leaves of the species of poison ivy. This examination revealed a yellow, amorphous substance on the stratum corneum of the lesions and a similar substance in and on leaves of the poison ivy plant, Toxicodendron radicans ssp. negundo. Associated with the pigmentary deposits there were distinct changes of acute irritant contact dermatitis superimposed upon allergic contact dermatitis. Our findings support the view that the black material is the oleoresin of the plant, and that this substance behaves both as an irritant and an allergen.
The allergens causing mango dermatitis have long been suspected to be alk(en)yl catechols and/or alk(en)yl resorcinols on the basis of observed cross-sensitivity reactions to mango in patients known to be sensitive to poison ivy and oak (Toxicodendron spp.). Earlier, we reported the 3 resorcinol derivatives: heptadecadienylresorcinol (I), heptadecenylresorcinol (II) and pentadecylresorcinol (III); collectively named 'mangol', as mango allergens. In this study, we extracted the 1st 2 components (I and II) from the Philippine mango, adjusted them to 0.05% concentration in petrolatum and patch tested the components on 2 subjects with mango dermatitis. Both subjects reacted to I. 1 subject also elicited a weaker positive reaction to II. To investigate the cross-reaction between mangol and urushiol, we also patch tested the same subjects with urushiol. The subject sensitive to II reacted to urushiol. 6 subjects with a history of lacquer contact dermatitis and positive reactions to urushiol were similarly patch tested. 5 persons reacted to I. 2 subjects also exhibited a slower but positive reaction to II. This is the 1st report in which heptadec(adi)enyl resorcinols known to be present in mango have been shown to elicit positive patch test reactions in mango-sensitive patients.
BACKGROUND: Allergic contact dermatitis caused by species of Lithraea genus (Anacardiaceae) is frequent in South America. Nevertheless, it has been scarcely reported in the literature, hitherto the responsible allergens have not been studied in some species. OBJECTIVE: The purpose of this study was to identify and characterize the allergenic compounds of Lithraea molleoides and brasiliensis, and to investigate the existence of cross-reactions with Toxicodendron allergens. METHODS: Twenty-seven South American subjects (17 with previous Lithraea dermatitis and 10 controls without any plant dermatitis) and four North American subjects who are highly sensitive to poison oak were tested with both purified Lithraea molleoides and brasiliensis extracts and poison oak urushiol. Lithraea extracts were analyzed by gas liquid chromatography (GLC) and gas chromatography-mass spectrometry (GC-MS). RESULTS: All 17 Lithraea-sensitive subjects reacted to poison oak urushiol and 13 of them also reacted to Lithraea molleoides and/or brasiliensis extracts. All 4 poison oak sensitive subjects reacted to poison oak urushiol and to Lithraea extracts. In both groups of sensitive subjects, the responses to poison oak urushiol were stronger and occurred at lower concentration than those to Lithraea extracts. The allergenic fraction in both Lithraea species consisted of: 3-pentadecylcatechol, 3-pentadecenylcatechol, 3-heptadecenylcatechol and 3-hepta-dec-dienilcatechol. CONCLUSION: We concluded that Lithraea molleoides and brasiliensis allergens are closely related to urushiol, although their eliciting potential seems to be lower in comparison with poison oak urushiol, even for Lithraea-sensitive subjects.
A synthesis of (15:1)-urushiol, urushiol monoene, 3-[(Z)-pentadec-8-enyl] catechol, 1,2-dihydroxy-3-[(Z)-pentadec-8-enyl] benzene, one of the toxic principles of Rhus toxicodendron and of Rhus vernicifera is described. 6-Chlorohexan-1-ol protected at the OH group with ethyl vinyl ether reacted with 2,3-dimethoxybenzaldehyde in the presence of lithium to give, after removal of the protective group with methanolic 4-toluenesulphonic acid, 1-(2,3-dimethoxyphenyl) heptane-1,7-diol. Catalytic hydrogenolysis in ethanol with palladium-carbon selectively afforded 7-(2,3-dimethoxyphenyl)heptane-1-ol accompanied by a small proportion of the 7-(3-methoxyphenyl)heptane-1-diol, formed by demethoxylation. Reaction of the dimethoxy compound with boron tribromide resulted in both bromination and demethylation to give 7-(2,3-dihydroxyphenyl) heptylbromide. This bromide in tetrahydrofuran (THF) containing hexamethylphosphoric triamide reacted with excess lithium oct-1-yne to give 3-(pentadec-8-enyl)catechol which, by catalytic hydrogenation in ethyl acetate containing quinoline, selectively formed the required cis product, 3-[(Z)-pentadec-8-enyl]catechol which was identical chromatographically and spectroscopically with urushiol monoene separated from the natural product.
A black, enamel-like deposit is frequently present on injured areas of poison ivy, poison oak, and poison sumac. This finding can also be produced deliberately as a field test for the toxic nature of the plant. Observing proper precautions, one crushes sap from leaves onto a sheet of white paper. The resulting stain should darken on exposure to the air if it came from a Toxicodendron. This test employs only one quality of these plants, and it is not, therefore, a substitute for other proved means of identification.
BACKGROUND: Poison ivy (toxicodendron) dermatitis is the most common allergic contact dermatitis in the USA. No studies have shown an effect of washing after a short period of time for the prevention of binding of urushiol to the skin. Objective To evaluate the efficacy of three different modes of postcontact prevention using a surfactant (Dial ultra dishwashing soap), an oil-removing compound (Goop), and chemical inactivation (a commercial product Tecnu). METHODS: A consented, unsponsored, volunteer experimental study on medical students from the University of Missouri School of Medicine, Kansas City. Each subject served as his/her own control, comparing four 2.5-cm exposed squares on the inner aspect of the forearm, three of which were treated and one untreated. RESULTS: Comparisons between the different agents were nonsignificant with P > 0.05. Each treatment, however, was significantly improved over the untreated control. CONCLUSIONS: Our study showed 70%, 61.8%, and 56. 4% protection with Tecnu, Goop, and Dial, respectively, when compared to the positive control, or to the possible maximum response, with a cost per ounce (in a local drug and automotive store) of $1.25, $0.07, and $0.07, respectively, for a decrease in protection that is nonsignificant.
Black-spot poison ivy dermatitis is a rare manifestation of a common condition. It occurs on exposure to the resins of the plants of the Rhus family also known as Toxicodendron. We describe 5 patients with black deposits on their skin and clothing after contact with poison ivy and review the literature reflecting different aspects of this phenomenon including clinical presentation, histologic findings, and historical background.
Allergic contact dermatitis to Toxicodendron radicans (poison ivy) is mediated by the hapten urushiol. An urushiol-specific, interleukin 2 (IL-2)-dependent T cell clone (RLB9-7) was generated from the peripheral blood of a patient with a history of allergic contact dermatitis to T. radicans. This clone proliferated specifically to both leaf extract and pure urushiol. Although the clone had the phenotype CD3+CD4+CD8+, proliferation to antigen was blocked by anti-CD8 and anti-HLA-A, B, C, but not by anti-CD4, suggesting that CD4 was not functionally associated with the T cell receptor. Furthermore, studies with antigen-presenting cells from MHC-typed donors indicated that the clone was MHC class 1 restricted. RLB9-7 was WT31 positive, indicating it bears the alpha beta T cell receptor. The clone lacked significant natural killer cell activity and produced only low levels of IL-2 or gamma-interferon upon antigen stimulation. Addition of RLB9-7 to autologous peripheral blood mononuclear cells in the presence of urushiol inhibited the pokeweed mitogen-driven IgG synthesis. This suppression was resistant to irradiation (2,000 rad) and was not seen when RLB9-7 was added to allogeneic cells, even in the presence of irradiated autologous antigen-presenting cells, suggesting that suppression was MHC restricted and not mediated by nonspecific soluble factors. However, RLB9-7 cells in the presence of urushiol inhibited the synthesis of tetanus toxoid-specific IgG by autologous lymphocytes, indicating that the suppression, although triggered specifically by urushiol, was nonspecific.