RESUMO
BACKGROUND: Occupational allergy among florists and people who work in cut flower production of Alstroemeria cultivars (Peruvian lily or Inca lily) has been previously reported. The allergen involved in sensitization is tulipalin A (alpha-methylene-gamma-butyrolactone). CASE REPORT: We describe the case of a 65-year-old woman who developed severe dermatitis on her right thumb, index and middle fingers and less severe dermatitis on her left palm and front of forearm with occasional itching of the neck and face after taking up home gardening activities, including cutting flowers such as Alstroemeria. METHODS: The patient and three healthy individuals were submitted to epicutaneous tests with the European standard series, the plant series, and stem portions of three suspected ornamental plants (Alstroemeria, Lilium and Zantedeschia), garlic, and onion. RESULTS: Patch tests performed in our patient, revealed an extreme reaction (+ + +) to Alstroemeria and alpha-methylene-gamma-butyrolactone, a strong reaction (+ +) to propolis and wood tar mix, a weak reaction (+) to balsam of Peru, an irritant reaction to garlic and negative results to diallyl disulfide and the other components investigated. Patch tests performed in the healthy individuals revealed negative. CONCLUSIONS: We stress the importance of Alstroemeria as a cause of allergic contact dermatitis not only in workers involved in the flower trade, but also in other people that come into contact with this plant in their leisure activities.
Assuntos
Alstroemeria/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Jardinagem , Dermatoses da Mão/etiologia , Idoso , Feminino , Dedos , Humanos , Fatores de RiscoRESUMO
Background: Occupational allergy among florists and people who work in cut flower production of Alstroemeria cultivars (Peruvian lily or Inca lily) has been previously reported. The allergen involved in sensitization is tulipalin A (alpha-methylene-gamma-butyrolactone). Case report: We describe the case of a 65-year-old woman who developed severe dermatitis on her right thumb, index and middle fingers and less severe dermatitis on her left palm and front of forearm with occasional itching of the neck and face after taking up home gardening activities, including cutting flowers such as Alstroemeria. Methods: The patient and three healthy individuals were submitted to epicutaneous tests with the European standard series, the plant series, and stem portions of three suspected ornamental plants (Alstroemeria, Lilium and Zantedeschia), garlic, and onion. Results: Patch tests performed in our patient, revealed an extreme reaction (+ + +) to Alstroemeria and alpha-methylene-gamma-butyrolactone, a strong reaction (+ +) to propolis and wood tar mix, a weak reaction (+) to balsam of Peru, an irritant reaction to garlic and negative results to diallyl disulfide and the other components investigated. Patch tests performed in the healthy individuals revealed negative. Conclusions: We stress the importance of Alstroemeria as a cause of allergic contact dermatitis not only in workers involved in the flower trade, but also in other people that come into contact with this plant in their leisure activities
Antecedentes: La alergia ocupacional entre las floristas y en los trabajadores de producción de flores de corte de cultivos de Alstroemeria (lirio Peruano o lirio Inca) fue ya objeto de descripción. La Tulipalina A (alfa-metileno-gama-butirolactona) es lo alergeno involucrado en la sensibilización. Caso clínico: se presenta un caso de una paciente de 65 años que ha iniciado una dermatitis grave en los 1º, 2º y 3º dedos de la mano derecha, bien como una dermatitis de intensidad moderada en la área palmar izquierda y vista anterior de lo antebrazo homolateral. Ocasionalmente, los síntomas se acompañan de prurito de la cara y cuello, en el decurso de actividades de jardinaje en su casa, incluyendo el corte de flores de Alstroemeria. Métodos: Fueron realizadas pruebas epicutáneas con la serie estándar europea, la serie de plantas, y porciones de tallo de tres plantas sospechas (Alstroemeria, Lilium y Zantedeschia), ajo y cebolla. Resultados: Las pruebas revelaron una reacción severa (+++) a Alstroemeria y alfa-metileno-gama-butirolactona, una reacción intensa (++) a propolis y mixtura de alquitranes de la madera, una reacción ligera (+) a bálsamo Perú, una reacción irritativa a ajo y resultados negativos a dialil disulfido, bien como a todos los demás estudiados. Conclusiones: Este caso clínico reporta la importancia de la Alstroemeria como inductor de dermatitis de contacto alérgica, non solo en trabajadores de floricultura, pero también en individuos comunes que puedan contactar con esta planta en sus actividades de tiempos libres