Contact urticaria and protein contact dermatitis in the Finnish Register of Occupational Diseases in a period of 12 years.

BACKGROUND: Although occupational contact urticaria (CU) and protein contact dermatitis (PCD) are considered frequent among workers with exposure to proteinaceous materials, data on occupations at risk and the main causes of these occupational skin diseases are relatively limited. OBJECTIVES: To report the causative agents and risk occupations for CU and PCD in the Finnish Register of Occupational Diseases (FROD). METHODS: We retrieved from the FROD all recognized cases of CU/PCD in the years 2005-2016. RESULTS: With 570 cases, CU and PCD constituted 11% of all recognized cases of occupational skin diseases in the study period. Occupations with the highest incidence of CU/PCD included bakers, chefs and cooks, farmers and farm workers, veterinarians, gardeners, and hairdressers. The most common causative agents were cow dander and flour and grain, followed by natural rubber latex (NRL) and other food. In food-related occupations, wheat and other flours were by far the most common cause of CU/PCD, with 76 cases, whereas fish and other animal-derived food caused 33 and other plant-derived food caused 23 cases. CONCLUSIONS: Apart from the Finnish peculiarity of cow dander allergy, a striking finding was a large share of CU/PCD caused by flours in food handlers as compared to other food.

Photoallergic contact dermatitis to 8-methoxypsoralen in Ficus carica.

BACKGROUND: Photocontact dermatitis to Ficus carica is induced by furocoumarins present in sap. These substances are generally considered to cause phototoxic reactions. OBJECTIVES: We conducted a patch test and histopathological study of patients with phytophoto contact dermatitis from the fig tree to evaluate the mechanism underlying the photoreaction. PATIENTS AND METHODS: Patch and photopatch testing with serial dilutions of two natural furocoumarins [5-methoxypsoralen and 8-methoxypsoralen (8-MOP)] contained in plant sap were performed in 47 patients. A synthetic furocoumarin, 4,5',8-trimethylpsoralen, was also tested. Histopathological analyses were made of some positive photoreactions. RESULTS: Positive photopatch tests reactions to 8-MOP were obtained in 12 of 47 patients, in 4 of them down to a concentration of 0.0001%. Patch tests and photopatch tests to the other two furocoumarins were negative. Histopathological findings on biopsies from positive photopatch tests to 8-MOP showed a dermatitis. CONCLUSIONS: Allergic photoreactions induced by contact with plants containing coumarins are generally regarded as chance findings. This study has demonstrated that phytophoto allergic contact dermatitis resulting from furocoumarins is not an exceptional finding, and should be suspected in subjects with diffuse clinical manifestations in photo-exposed but also non-exposed sites. To differentiate allergic from toxic photoreactions, patch tests need to be performed with serial dilutions of furocoumarins. Histological analysis of a biopsy sample from a positive test site will reveal alterations compatible with a photoallergic contact dermatitis.

Effects of Ficus deltoidea aqueous extract on hematological and biochemical parameters in rats.

Aqueous extract of Ficus deltoidea var. agustifolia was examined for the subchronic toxicity effects in rats. Groups of 10 rats were given the extract daily by oral gavage for 90 days at 0 (control), 100 and 300mg/kg/body weight, respectively. Blood samples were collected upon sacrificed and analysed for haemogram and biochemistry. The results showed there were no significant changes of the blood parameters in all treated groups compared to the control.

Phytophotodermatitis due to Ficus carica.

The genus Ficus belongs to the Moraceae (the mulberry family). Figs can cause irritant or phototoxic reactions. Phytophotodermatitis is a common cutaneous phototoxic reaction. Contact with plant-derived phototoxic substances (furocoumarins or psoralens) followed by sunlight exposure produces the clinical lesions. Here, we present a case of phytophotodermatitis after contact with fig fruits and leaves. The vesicular dermatitis was primarily located in areas of vitiligo.

Phytophotodermatitis caused by contact with a fig tree (Ficus carica).

Two arborists presented acutely with blistering eruptions affecting their forearms, hands, and fingers. The previous day, both men had pruned branches from a large fig tree, Ficus carica, which had sustained damaged during a storm. The following morning, both complained of a burning discomfort which rapidly evolved into erythema and bullae on skin that had been in direct contact with the tree branches. These symptoms gradually resolved over 4 to 6 weeks. Although phytophotodermatitis from Ficus carica has been reported, it is often poorly recognised and there is a need to raise awareness amongst arborists, orchardists, forestry workers, gardeners, and health professionals.

Phytophotodermatitis caused by contact with a fig tree (Ficus carica).

Two arborists presented acutely with blistering eruptions affecting their forearms, hands, and fingers. The previous day, both men had pruned branches from a large fig tree, Ficus carica, which had sustained damaged during a storm. The following morning, both complained of a burning discomfort which rapidly evolved into erythema and bullae on skin that had been in direct contact with the tree branches. These symptoms gradually resolved over 4 to 6 weeks. Although phytophotodermatitis from Ficus carica has been reported, it is often poorly recognised and there is a need to raise awareness amongst arborists, orchardists, forestry workers, gardeners, and health professionals.

[The return of the prodigal child or allergy to ficus]. / Le retour de l'enfant prodigue ou l'allergie au ficus.

Ficus benjamina (FB), the weeping fig, belonging to the Moracea family, is now widely used as an indoor ornamental plant in houses and offices. Its latex can be responsible of IgE allergies : rhinoconjunctivitis, asthma, angiooedema, pruritus, anaphylactic shock. In some occupations such as gardeners, caretakers of plants, it can induce a contact urticaria. Most of these patients are atopics. We describe a case of non-occupational, indoor related rhinoconjunctivitis in a non-atopic patient. Prick-test and RAST to FB latex were positive and removal of the ficus plant resolved their symptoms confirming the etiologic role of the plant. The patient did not demonstrate sensitization to other common allergens (except weeds) involved in respiratory (latex of Hevea brasiliensis, mites...) and food allergies (negativity of the prick-tests for fig, avocado, banana, kiwi). Now, FB is a new hidden allergen in the house. Questionning for its presence and testing it should be considered; as it should be introduced in the standard prick-test panel.

Fig and mulberry cross-allergy.

BACKGROUND: Hypersensitivity reactions to ingestion of figs (Ficus carica) and mulberries (Morus nigra and Morus alba) are considered uncommon and have never been reported as occurring in the same patient. OBJECTIVE: To determine whether hypersensitivity to figs and mulberries can induce cross-allergy. METHODS: We describe 3 cases of associated fig and mulberry allergy in 3 patients with multiple sensitizations to food allergens (mostly fruit) and airborne allergens. The presence of specific IgE was investigated by skin prick tests and radioallergosorbent tests. RESULTS: The 3 patients had a convincing clinical history of food allergy caused by eating fresh figs, and in all 3 cases clinical and/or laboratory evidence of sensitization to mulberries was also collected. CONCLUSIONS: We reason that Ficus and Morus are closely related genera of the Moraceae family and speculate that hypersensitivity to figs and mulberries might be associated as the result of allergen cross-reactivity rather than mere coincidence.

[The prevalence of skin and mucosal symptoms in gardeners handling Ficus benjamina (weeping fig) and Hedera helix (ivy). A cross-sectional study]. / Praevalensen afhud- og slimhindesymptomer blandt gartnere der omgås Ficus benjamina (stuebirk) og Hedera helix (vedbend). Et tvaersnitsstudie.

INTRODUCTION: Allergic and toxic initiative symptoms from skin, eyes and respiratory tract are well known among gardeners This study reports the prevalence of these symptoms among gardeners working with Ficus Benjamina (Fb) and Hedera helix (Hh). MATERIAL AND METHODS: A questionnaire concerning allergic/toxic-irritative symptoms from skin, eyes and respiratory tract were forwarded to 57 gardeners. A total of 49 questionnaires were returned and matched on sex and age with a control group. A number of 46 women and 52 men participated, with a mean age of 39 (SD 9.7). Differences in frequencies of symptoms were expressed as odds ratio (OR) with a security level of 95% after conditioned logistic regression; other results were calculated from Mantel-Haenzel test. RESULTS: There were more complaints among gardeners compared to the control group f as to symptoms of asthmatic bronchitis (OR 4.6 [0.98-21.2]), rhino conjunctivitis (OR 6.4 [2.1-20.2]) and skin symptoms (OR 4.3 [1.5-12.5]). The symptoms were especially profound among the caretakers of Fb and Hh and to a lesser degree among gardeners working in greenhouses growing Fb and Hh. The symptoms of the gardeners were to a higher degree independent of the season (OR 3.1 [1.1-9]), related to working environment (OR 16.1 [3.3-78.9]) and indoor work (OR 24 [4.8-118.7]). DISCUSSION: This study seems to demonstrate high frequencies of apparently allergic and/or toxic irritative symptoms among gardeners and should be followed by a study including clinical examinations. With knowledge of the allergenic and toxic irritative properties of Fb and Hh it seems problematic that these plants are found in such high numbers in public and private places. Allergic testing including these plants should be performed to a higher degree than is actually the case.

An unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology.

Medicinal plant extracts are commonly used worldwide. Their use relies mostly on historical and anecdotal evidence and might be so hazardous. Phytophotodermatitis is a well-known entity that is caused by the sequential exposure to certain species of plants containing furocoumarins and then to sunlight. In this article, superficial burn lesions caused by fig leaf decoction that was applied to a patient's both upper extremity as a remedy for a dermatitis of unknown etiology is reported. Direct sun exposure is an essential component of phytophotodermatitis. All reported cases to date have in common that patients are exposed to direct sunlight or to artificial UVA lights (like solarium) of varying durations. In our case neither direct sun exposure, other than inevitable indoor UVA influence, nor blister formation was present. The etiologic factors, symptoms, signs, course, and treatment alternatives for phytophotodermatitis are also reviewed briefly.