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Updated: Jan 30, 2026
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Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
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[A recrute with blisters on the cheek]
Maarten W G A Bronkhorst1,2, Albert F Pull Ter Gunne3
1Haaglanden Medisch Centrum, afd. Heelkunde, Den Haag.
Nederlands Tijdschrift Voor Geneeskunde
|January 15, 2019
Summary
Direct contact with the toxic sap of the manzanilla tree (Hippomane mancinella) caused severe bullous dermatitis in a soldier. This common tropical tree poses a significant skin contact hazard, even from its leaves.
Area of Science:
- Dermatology
- Toxicology
- Botany
Background:
- Manzanilla tree (Hippomane mancinella) is a toxic plant found in tropical regions, known for its hazardous sap.
- The Euphorbiaceae family includes many toxic plants, with all parts of the manzanilla tree being poisonous.
Observation:
- A 37-year-old soldier developed blisters on his cheek within 30 minutes of a military exercise in Curaçao's mangroves.
- The bullous dermatitis was a direct result of contact with sap from the bark of a manzanilla tree.
Findings:
- The manzanilla tree's sap is a potent irritant, causing acute bullous dermatitis upon skin contact.
- Even environmental factors like raindrops falling from manzanilla leaves can induce similar skin reactions.
Implications:
- Awareness of the manzanilla tree's toxicity is crucial for individuals in endemic areas, especially during outdoor activities.
- Symptomatic treatment is typically effective, leading to dermatitis healing within weeks, but prevention is key.
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