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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Systemic allergic dermatitis caused by sesquiterpene lactones.

Evy Paulsen1

  • 1Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, 5000, Odense C, Denmark.

Contact Dermatitis
|August 30, 2016
PubMed
Summary

Patients with Compositae allergies may react to ingested plants, causing systemic allergic dermatitis. While often anecdotal, scientific evidence confirms reactions to sesquiterpene lactones in certain Compositae species.

Keywords:
AsteraceaeCompositaeLactuca sativaLaurus nobilischallengeherbal teasesquiterpene lactonessystemic allergic dermatitis

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Area of Science:

  • Allergen immunology
  • Dermatology
  • Plant chemistry

Background:

  • Patients with Compositae sensitization are advised to avoid plant-derived foods and remedies.
  • Evidence linking Compositae ingestion to systemic allergic dermatitis is largely anecdotal, lacking robust scientific data.
  • Sesquiterpene lactones are suspected allergens in these plants.

Purpose of the Study:

  • To review the scientific evidence for systemic allergic reactions caused by ingesting Compositae plants.
  • To investigate the role of sesquiterpene lactones in systemic allergic dermatitis.
  • To identify specific Compositae species implicated in such reactions.

Main Methods:

  • Review of clinical reports and case studies.
  • Analysis of existing scientific literature on Compositae sensitization.
  • Discussion of oral challenge studies and immunological mechanisms.

Main Results:

  • Confirmed systemic allergic dermatitis from sesquiterpene lactones, particularly strong allergens like costunolide.
  • Identified several Compositae species (e.g., lettuce, chamomile, artichoke) as potential triggers for systemic reactions.
  • Observed both humoral and cell-mediated immune responses in some cases, complicating symptom attribution.

Conclusions:

  • Systemic allergic dermatitis from ingested Compositae, mediated by sesquiterpene lactones, is scientifically supported, though prevalence requires further study.
  • Strong contact allergens are more convincingly linked to systemic reactions than weak ones.
  • Further research is needed to clarify the prevalence and pathogenesis of these reactions.