[Allergic reaction after contact with Hura crepitans (sandbox tree)]

We describe a 36-year-old female patient with angioedema-like swellings and rhinoconjunctivitis for 1 year occurring exclusively at her home. The clinical history revealed no correlation with foods, food additives, drugs, or aeroallergens. The complaints always started immediately after contact with the sandbox tree (Hura crepitans) placed in her apartment. Scratch testing resulted in a two-fold positive reaction towards leaves and stem, while five controls remained negative. Thus we suggest the reaction of the patient to be allergic in nature. Hura crepitans belongs to the family of Euphorbiaceae, whose largest genera are Euphorbia and Croton. The toxic reactions to the milky sap, the so-called latex, of these plants are caused by ingredients such as phorbol esters, croton oil, lectins, and terpens. Various terpens are also well known as allergens. Phytotoxic and phytoallergic reactions are growing increasingly important and should therefore be included in the differential diagnosis in dermatology.