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Erythema multiforme due to contact with weeds: a recurrence after patch testing.
M Jovanović1, N Mimica-Dukić, M Poljacki
1Medical Faculty of Novi Sad, University of Novi Sad, Clinic for Dermatovenerologic Diseases, Clinical Center, Yugoslavia. zip@EUnet.yu
Contact Dermatitis
|March 19, 2003
Summary
Erythema multiforme (EM) is a rare complication of patch testing (PT). This case highlights EM recurrence after PT with common weeds, revealing specific plant allergens and unusual lesion presentation.
Area of Science:
- Dermatology
- Allergology
- Contact Dermatitis Research
Background:
- Erythema multiforme (EM) is an uncommon complication of patch testing (PT).
- Recurrent EM episodes in a patient were linked to weed exposure.
- No recent triggers like infections or vaccinations were identified.
Observation:
- Patch testing and photopatch testing were performed with fresh plants and standard series.
- Intradermal testing showed a strong reaction to mixed weed pollens.
- Eczematous reactions occurred with common chickweed, dandelion, field-milk thistle, and white clover.
Findings:
- Photoaggravation was observed with common chickweed and dandelion.
- Positive patch test reactions were noted for alantolactone.
- EM developed during patch testing, similar to previous episodes.
- Thin layer chromatography identified allergens like borneol and menthol in common chickweed essential oil.
Implications:
- This case suggests weeds can trigger EM and recur after patch testing.
- The absence of blistering or eczematous lesions in this EM case is highly unusual.
- This is the fourth reported instance of EM associated with patch testing globally.