Occupational contact dermatitis toward sesquiterpene lactones in a florist

Many plants and flowers can cause dermatitis in florists, growers, and others working in the industry. In the United States, Alstromeria, also called Peruvian Lily, has frequently been reported to cause hand eczema in floral workers. This interesting report details sesquiterpene lactone allergy in the occupational setting. Fortunately, in this case, it seems that resolution of the dermatitis was achieved fairly rapidly by avoiding the occupational situation. Unfortunately, for many of our patients with airborne compositae dermatitis, there is no way to avoid the allergen; therefore, many of these individuals develop severe, chronic recalcitrant dermatitis requiring aggressive therapy. Diagnosis of this condition is not always easy, as it appears that the sesquiterpene lactone mix allergen that we have commercially available misses a number of cases, at least in the United States. Better characterization of the allergens involved and better supply of allergenic extracts for testing is critical to improve our diagnostic ability.