Which plants can cause skin irritation in your garden. How to identify plants with irritant sap. What precautions should you take when handling potentially harmful plants. How to treat skin reactions caused by plant sap.

Understanding the Dangers of Plants with Irritant Sap

While severe plant poisoning is rare in the UK, certain plants possess irritant sap that can cause various skin reactions. These range from minor rashes to more serious conditions like blistering and temporary vision impairment. Some plants, such as giant hogweed (Heracleum mantegazzianum), contain sap that increases skin sensitivity to sunlight, potentially resulting in severe sunburn and long-lasting skin discoloration.

It’s crucial to understand which plants pose potential risks and take appropriate precautions when handling them. This knowledge is particularly important for gardeners, outdoor enthusiasts, and parents of young children. By familiarizing yourself with these plants, you can enjoy your garden safely while minimizing the risk of unpleasant reactions.

Top 10 Plants with Irritant Sap to Watch Out For

1. Aconitum (Monkshood)

Aconitum napellus, commonly known as monkshood, wolfsbane, or aconite, contains a potent toxin called aconitine. All parts of the plant are toxic, but the sap is particularly irritating to the skin. Contact can cause burning sensations in the lips and mouth, vomiting, diarrhea, and muscle spasms.

2. Alstroemeria (Peruvian Lily)

Every part of alstroemeria contains tulipalin, a compound that can cause skin irritation, especially when plant tissues are damaged during pruning or deadheading. Ingesting the sap may lead to mild vomiting or diarrhea, while skin contact can result in rashes, irritation, and occasionally blisters and eye irritation.

3. Echium (Viper’s Bugloss)

The sap from all echium species, including viper’s bugloss (Echium vulgare), can cause skin irritation. This may manifest as a burning sensation and potential blistering. If ingested, the sap can be mildly toxic.

4. Capsicum annuum (Chili Peppers)

While the fruits of Capsicum annuum (chili and sweet peppers) are edible, their sap can irritate the skin and potentially cause blistering. Extra caution should be taken when handling these plants, especially during harvesting or pruning.

5. Euphorbia (Spurge)

Euphorbias are known for their milky sap, which is highly irritating to both skin and eyes. Contact with the sap can cause skin burning, and if it enters the eyes, it may result in burning sensations, swelling, and temporary vision loss for up to two weeks. When handling euphorbias, it’s essential to wear both gloves and eye protection.

6. Chrysanthemum

Chrysanthemum sap contains alantolactone, a phytochemical compound that can irritate skin upon contact and increase sensitivity to sunlight. This photosensitivity can lead to more severe sunburns if exposed to UV rays after handling the plant.

7. Ficus benjamina (Weeping Fig)

The weeping fig, a popular houseplant, has sap that can cause allergic reactions, including dermatitis and increased sensitivity to sunlight. This is especially true for individuals with latex allergies. In rare and extreme cases, exposure to ficus sap can even result in anaphylactic shock.

8. Pastinaca sativa (Parsnip)

Like all members of the carrot family, parsnips have irritant sap that can be absorbed by the skin. When combined with sunlight exposure, this can lead to extreme sunburn, itching, and blistering. This reaction, known as phytophotodermatitis, can be particularly severe.

9. Philodendron

Another common houseplant, philodendron can cause mild irritation upon contact with its sap. While the sap is also poisonous when ingested, it typically only poses a threat in large doses. Nevertheless, it’s important to handle these plants with care, especially around children and pets.

10. Nerium oleander

Oleander contains numerous toxins throughout all parts of the plant. While ingestion can cause serious illness and, in extreme cases, death, contact with the sap can result in skin rashes, burns, and blurred vision. Extra precautions should be taken when handling this highly toxic plant.

Identifying Plants with Irritant Sap

Recognizing plants with irritant sap is crucial for avoiding potential skin reactions. Here are some key characteristics to look out for:

• Milky or colored sap that oozes when stems or leaves are broken
• Hairy or fuzzy leaves and stems
• Plants with a strong or unpleasant odor
• Plants with thorns, spines, or sharp edges
• Umbrella-shaped flower clusters (common in many toxic plants)

Remember, not all plants with these characteristics are harmful, but they warrant caution. When in doubt, consult a plant identification guide or a local horticulturist.

Precautions When Handling Potentially Harmful Plants

To minimize the risk of skin irritation when working with plants that may have irritant sap, follow these precautions:

1. Wear protective clothing, including long sleeves, pants, and closed-toe shoes
2. Use thick, impermeable gloves when handling plants
3. Wear eye protection, especially when pruning or working with euphorbia species
4. Avoid touching your face or eyes while working with plants
5. Wash your hands thoroughly with soap and water after gardening
6. Clean and disinfect any tools used on plants with irritant sap
7. Educate children about potentially harmful plants and supervise them in the garden

By following these guidelines, you can significantly reduce the risk of skin irritation and other adverse reactions when working with plants.

Treating Skin Reactions Caused by Plant Sap

If you come into contact with irritant plant sap, take the following steps:

1. Rinse the affected area thoroughly with cool water for at least 15 minutes
2. Gently wash the area with mild soap and water
3. Apply a cool compress to reduce inflammation and soothe the skin
4. Use over-the-counter hydrocortisone cream to alleviate itching and inflammation
5. Take an oral antihistamine if symptoms persist or are severe
6. Seek medical attention if you experience severe reactions or if symptoms worsen

For eye exposure, flush the eyes with clean water for at least 15 minutes and seek immediate medical attention.

Alternative Plants for Child-Friendly Gardens

If you have young children or frequently host families with kids, consider replacing potentially harmful plants with safer alternatives. Here are some child-friendly options:

• Marigolds (Tagetes): Bright, cheerful flowers with non-toxic properties
• Sunflowers (Helianthus annuus): Large, impressive blooms that are safe for children
• Nasturtiums (Tropaeolum): Colorful flowers with edible leaves and petals
• Pansies (Viola × wittrockiana): Hardy, vibrant flowers that are non-toxic
• Snapdragons (Antirrhinum): Fun, interactive flowers that are safe for kids
• Lamb’s Ear (Stachys byzantina): Soft, velvety leaves that are safe to touch

These plants not only provide a safer environment for children but also offer opportunities for hands-on learning about gardening and nature.

The Importance of Plant Education and Awareness

Understanding the potential risks associated with certain plants is crucial for gardeners, outdoor enthusiasts, and parents. By educating yourself and others about plants with irritant sap, you can create a safer environment while still enjoying the beauty and benefits of gardening.

Consider these steps to promote plant awareness:

• Attend local gardening workshops or classes to learn about native and potentially harmful plants in your area
• Use plant identification apps or guides to familiarize yourself with various species
• Teach children about safe plant handling practices and which plants to avoid touching
• Share your knowledge with friends, family, and neighbors to create a more informed community
• Regularly update your understanding of plant safety, as new information may become available over time

By fostering a culture of plant awareness and education, we can all contribute to safer and more enjoyable outdoor experiences.

Balancing Beauty and Safety in Your Garden

While it’s important to be aware of plants with irritant sap, this knowledge shouldn’t deter you from enjoying gardening or appreciating the beauty of various plant species. With proper precautions and understanding, you can create a garden that is both visually stunning and safe for all visitors.

Consider these tips for balancing beauty and safety in your garden design:

1. Strategically place potentially harmful plants in less accessible areas of your garden
2. Use clear signage or markers to identify plants with irritant sap
3. Create designated “safe zones” with child-friendly plants for young visitors
4. Incorporate a variety of non-toxic, colorful plants to maintain visual interest
5. Regularly maintain your garden to keep potentially harmful plants well-groomed and contained

By thoughtfully planning your garden layout and plant selection, you can create a space that is both beautiful and safe for all to enjoy.

The Role of Proper Plant Care in Minimizing Risks

Proper plant care not only ensures the health and vitality of your garden but can also help minimize the risks associated with plants that have irritant sap. Well-maintained plants are less likely to cause accidental contact or unexpected reactions.

Here are some plant care practices that can help reduce risks:

• Regular pruning to control plant size and remove damaged or diseased parts
• Proper watering and fertilization to maintain plant health and reduce stress
• Implementing good garden hygiene by removing fallen leaves and debris
• Using appropriate supports for climbing or sprawling plants to prevent unexpected contact
• Monitoring plants for signs of pests or diseases that may cause them to produce more irritant compounds

By implementing these practices, you can create a healthier garden environment that is safer for both gardeners and visitors.

Seasonal Considerations for Plants with Irritant Sap

The potential for skin irritation from plant sap can vary throughout the year. Understanding these seasonal variations can help you take appropriate precautions at different times.

Consider the following seasonal factors:

1. Spring: Many plants are in active growth, producing more sap. Extra caution is needed during pruning and planting activities.
2. Summer: Increased sun exposure can exacerbate reactions to photosensitizing plants like giant hogweed or parsnip.
3. Fall: Deciduous plants may have higher concentrations of irritants in their leaves before they drop.
4. Winter: Dormant plants generally pose less risk, but evergreen species with irritant sap still require caution.

Adapting your gardening practices and protective measures according to these seasonal changes can help minimize the risk of skin irritation throughout the year.

Creating a Safe Gardening Environment for All

Ultimately, the goal is to create a garden that can be enjoyed safely by everyone, from experienced gardeners to curious children. By combining knowledge of potentially harmful plants with proper safety measures and thoughtful garden design, you can achieve this balance.

Key takeaways for creating a safe gardening environment include:

• Educating yourself and others about plants with irritant sap
• Implementing proper safety measures when handling potentially harmful plants
• Designing your garden with both beauty and safety in mind
• Maintaining plants properly to minimize risks
• Adapting your gardening practices to seasonal changes
• Fostering a culture of plant awareness and education in your community

By following these guidelines, you can create a garden that is not only visually appealing but also safe and enjoyable for all who visit. Remember, with the right knowledge and precautions, you can fully appreciate the diversity and beauty of the plant world while minimizing potential risks.

10 Plants with Irritant Sap

While serious poisoning from plants is extremely unlikely in the UK, there are some plants we should be careful around, especially when pruning, weeding, cutting flowers or deadheading. These plants have irritant sap that can cause anything from a minor rash to blistering of the skin and sometimes – in extreme cases – temporary blindness. What’s more, some plants, such as giant hogweed, Heracleum mantegazzianum, have sap which causes the skin to become extremely sensitive to sunlight. This can result in severe sunburn and potentially long-term skin discolouration.

There’s no need to panic. Simply by wearing gloves and long sleeves while handling these plants is enough to prevent contact. However, it’s worth knowing which plants could affect you, and you may wish to teach your children of the dangers of certain plants and even avoid growing some types of plants while your children are very young.

Browse our list of plants with irritant sap, below.

Aconitum

Plants with irritant sap – aconitum

Aconitum napellus is also known as monkshood, wolfsbane and aconite. It contains a powerful toxin, aconitine, which can kill people who come into contact with it. All parts of the plant are toxic but the sap in particular is a skin irritant, causing burning of the lips and mouth, vomiting, diarrhoea and spasms.

Alstroemeria

Plants with irritant sap – alstroemeria

Every part of alstroemeria can be toxic, thanks to the compound tulipalin, which is produced when plant tissues are damaged such as when pruning or deadheading. Ingesting the sap can cause mild vomiting or diarrhoea, while skin contact can cause a rash or irritation and, rarely, blisters and eye irritation.

Echium

Plants with irritant sap – echium

Sap from all echiums, including viper’s bugloss, Echium vulgare, can cause skin irritation such as a burning sensation and possible blistering, and be mildly toxic if ingested.

Capsicum annuum

Plants with irritant sap – Capsicum annuum

While the fruits of Capsicum annuum, which we know better as chillies and sweet peppers, are completely edible, the sap can irritate the skin and potentially cause it to blister.

Euphorbia

Plants with irritant sap – euphorbia

Euphorbias have a particularly milky sap, which is extremely irritating to the skin and eyes. The sap can cause burning to the skin and if it comes into contact with your eyes then you may experience a burning sensation, swelling and temporary loss of vision for up to two weeks. As well as wearing gloves when handling euphorbias, gardeners should also wear eye protection.

Chrysanthemum

Plants with irritant sap – chrysanthemum

Chrysanthemum sap contains the phytochemical compound Alantolactone, which can irritate skin on contact and increase sensitivity to sunlight.

Weeping fig

Plants with irritant sap – Ficus

Weeping fig, Ficus benjamina, is a popular houseplant. However, contact with its sap can cause an allergic reaction including dermatitis and increased sensitivity to sunlight, especially for those who are allergic to latex. In rare and extreme cases, contact with, or even exposure to, ficus sap, can result in anaphylactic shock.

Parsnip

Plants with irritant sap – parsnip

Parsnips, like all members of the carrot family have irritant sap that’s absorbed by the skin and, when combined with sunshine, can cause extreme sunburn, itching and blistering.

Philodendron

Plants with irritant sap – philodendron

Another popular house plant, philodendron can cause mild irritation on contact with the sap. The sap is also poisonous when ingested, but only in large doses.

Nerium oleander

Plants with irritant sap – Nerium oleander

Oleander contains many toxins, which are found in all parts of the plant. Ingestion of any part of the plant can cause serious illness and, in extreme cases, death. Contact with the sap can cause skin rashes and burns, and blurred vision.

Other plants with irritant sap:

• Anthurium
• Arisaema
• Arum
• Calla palustris
• Croton
• Daphne mezereum
• Hyacinthus
• Iris
• Lobelia
• Narcissus

Skin Problems from Outdoor Plants

The Bottom Line

Mechanical injury, chemical irritation, allergic reactions, and light-sensitivity are all possible effects of exposure to certain plants—not just poison ivy.

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The Full Story

Poison ivy gets all the press, but other outdoor plants can pose problems, too. Mechanical injury, chemical irritation, allergic reactions, and light-sensitivity are all possible effects of exposure to certain plants. People who garden and enjoy outdoor recreation should take some precautions.

Injury to the skin is common from exposure to thorns, cactus spines, and spiny or sharp leaves. And, stinging nettles really do sting! Punctures from rose thorns are well known. There are thorns on the ornamental shrub barberry. The tips of holly leaves are sharp enough to puncture the skin. Spines from cacti are strong enough to do the same. Even small, nearly invisible “hairs” on cacti can be strong enough to puncture skin. Fibers on tulip and daffodil bulbs can cause injury, as can nearly invisible “hairs” on dogwood leaves. Sometimes, the puncture itself is the only injury. In other cases, histamine is released; the victim has a puncture wound plus local itching. And, any break in the skin can lead to infection.

Many plants can cause chemical irritation, including some ornamental plants. Anemones, daisies, clematis, snow-on-the-mountain (a Euphorbia), and hellebore are among the plants which can cause skin rashes and irritation if handled. Chili peppers, whether ornamental or culinary, can cause intense burning if they are handled without gloves.

In addition to poison ivy, English ivy (Hedera helix and related species) can cause an allergic skin reaction. Even though the two plants aren’t related, allergic reactions have been reported in gardeners after trimming English ivy and in children who played with English ivy or climbed trees covered with it. Itching, rashes, and weepy blisters can occur.

Some plants can lead to injury if sap or juice drips onto skin and that skin is then exposed to sunlight. A red rash and possibly blisters occur. As the skin heals, the affected areas may become much darker than usual; these darkened areas may take weeks or months to fade. Garden plants that can cause this reaction include carrots, parsnips, dill, fennel, and celery. Citrus juice can cause the same effect; if you spill a drink with orange, lemon, or lime juice on your bare skin, be sure to wash it off quickly.

Preventing these itchy, blistery, uncomfortable skin reactions involves some common-sense steps.

• When gardening or doing yard work, cover as much skin as you can. Wearing gardening gloves can prevent many plant materials from piercing your skin. Long pants and sleeves can prevent “weed whacker” dermatitis – the rashes that occur when pieces of grass, weeds, poison ivy, and other plant materials are thrown back forcefully onto skin.
• Avoid touching your face and eyes when working with outdoor plants.
• If you know you have plant material, juices, or sap on your skin, wash quickly with plenty of running water.

Here’s what to do if you are injured by some type of plant material.

• Wash the area thoroughly with plenty of running water and soap.
• If your tetanus immunization is more than five years old, contact your health care provider; you may need a booster.
• Use over-the-counter steroid cream if needed to control itching and irritation. Over-the-counter antihistamines, such as diphenhydramine, may help, too. If these don’t control your symptoms, or if they seem to get worse, contact your health provider. You may need prescription-strength medicines.
• Observe the area for such signs of infection as red streaks around the area, swelling, pus, or a lot of discharge. If this happens, see your health care provider. If you have questions about plants or plant poisons, call Poison Control at any time: 1-800-222-1222.

Swallowed a possibly poisonous plant? Use the webPOISONCONTROL^{® online tool or call Poison Control at 1-800-222-1222. Expert help is available 24 hours a day, online or by phone.}

Rose Ann Gould Soloway, RN, BSN, MSEd, DABAT emerita
Clinical Toxicologist

Poisoned?

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1-800-222-1222


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HELP ME online

Prevention Tips

• When gardening or doing yard work, cover as much skin as you can.
• Avoid touching your face and eyes when working with outdoor plants.
• If you have plant material, juices, or sap on your skin, wash quickly with plenty of running water.

This Really Happened

An 11-year-old boy and his friend were clearing weeds near his home. The weeds were later identified as cow parsnip (Heracleum lanatum). The next day, he had pain, redness, and blisters on both arms. (The other children had some redness on their arms.) Within three days, the blisters became very large, painful, and full of fluid. Treatment involved removing skin over the blisters and treating the areas like burns, with wound care and physical therapy. The rash improved, but very slowly. Several months later, the areas remained darker than his normal skin color.

Reference: McCue AK. Clinical images: a mystery. Wilderness and Environmental Medicine. 2007;18:156-159.

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For More Information

The “Don’t Touch Me Plants” (Purdue University)

Poisonous and non-poisonous plants: An illustrated list

Daffodils (The Poison Post^®)

Foxglove (The Poison Post^®)

Azaleas and rhododendrons (The Poison Post^®)

Lime Juice + Sun Can Cause Skin Rashes (The Poison Post^®)

References

Jones JM, White IR, White ML, McFadden JP. Allergic contact dermatitis to English Ivy (Hedera helix) – a case series. Contact Dermatitis. 2009;60:179-180.

Modi GM, Doherty CB, Katta R, Orengo IF. Irritant contact dermatitis from plants. Dermatitis. 2009;20:63078.

Sasseville D. Clinical patterns of phytodermatitis. Derm Clin. 2009;27:299-308.

Poisoned?

Call


1-800-222-1222


or

HELP ME online

Prevention Tips

• When gardening or doing yard work, cover as much skin as you can.
• Avoid touching your face and eyes when working with outdoor plants.
• If you have plant material, juices, or sap on your skin, wash quickly with plenty of running water.

This Really Happened

An 11-year-old boy and his friend were clearing weeds near his home. The weeds were later identified as cow parsnip (Heracleum lanatum). The next day, he had pain, redness, and blisters on both arms. (The other children had some redness on their arms.) Within three days, the blisters became very large, painful, and full of fluid. Treatment involved removing skin over the blisters and treating the areas like burns, with wound care and physical therapy. The rash improved, but very slowly. Several months later, the areas remained darker than his normal skin color.

Reference: McCue AK. Clinical images: a mystery. Wilderness and Environmental Medicine. 2007;18:156-159.

Plants harmful to the skin

Maria Zhuravleva, a dermatologist at the DocDeti clinic, prepared an article about plants that can harm.

Many plants are much more dangerous to humans than we think. Poisoning, skin irritation and other undesirable effects can be obtained from contact with flowers, leaves, sap and even roots of certain plants.

For example:

1. The juice of ash-tree and hogweed Sosnovsky contains furanocoumarins, which have phototoxic properties. Getting on the skin, the juice of the plant, under the influence of UV rays, causes burns.

2. Buttercup juice contains ranunculol, which, when it gets on the skin, causes contact dermatitis.

3. The flowers and stems of marigolds contain thiophenes with phototoxic properties (see item 1)

4. Any part of the castor plant contains ricin, most of all in the seeds of the plant. Juice, getting on the skin causes contact dermatitis, and once inside it can cause acute poisoning.

5. Ivy has poisonous stems and leaves. The sap of the plant causes a severe blistering burn. The consumption of leaves by children or animals leads to acute poisoning.

6. Euphorbia: croton and spurge. The sap of these plants is poisonous. On the skin – leads to severe irritation, once inside causes vomiting.

7. Dieffenbachia juice is very dangerous if it gets into your mouth. This can lead to paralysis of the vocal cords and loss of voice.

8. Primula contains alkaloids that cause nausea and dizziness, and the juice of leaves and flowers – dermatitis.

What measures to take if there was contact with poisonous plants?

• Most importantly, eliminate contact with the irritant, then wash the contact area with plenty of soapy water.
• The juice of some plants (hogweed, ash) contains substances that are activated when they are exposed to UV rays – photosensitizers. Therefore, it is imperative to cover the area from the sun that has suffered from the ingress of juice on it.

At least a week is required to wear closed clothes. If the juice is on your face, then use a hat and a maximum SPF. If possible, you should not leave the house at all.

If dermatitis could not be avoided:

• For redness, irritation, itching, the first line therapy is creams with topical corticosteroids, if the form is mild, then chilled creams and talkers with zinc, calamine will help.
• When blisters appear, try not to touch them, keep them intact for as long as possible (you can bandage them, but be very careful). You can’t burst bubbles! Firstly, it will be painful, secondly, it is possible to allow the accession of a secondary infection.
• If the temperature rises, severe pain, then you can take NSAIDs and contact a pediatric dermatologist.
• If a large surface is affected, hospitalization is possible.

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Photophytodermatitis

9 0002 A skin disease that develops under the influence of chemicals contained in plants that have a photosensitizing effect is called photophytodermatitis.

Most often, the development of photophytodermatitis is associated with the presence of coumarins or furocoumarins in plant parts. This group of photosensitizing compounds that increase the sensitivity of the skin to light. Coumarins and furocoumarins are most often found in plants belonging to the legume, Ranunculaceae, Umbelliferae, Rutaceae, etc. families.

M. Lenković et al. [1] describe the development of photophytodermatitis after contact with plants in their region for 3 years. The authors emphasize that contact with plants can lead to the development of phototoxic or photoallergic (rarely) reactions. Phototoxic reactions occur after skin contact or ingestion of plants containing furocoumarins, i.e. psoralens, subject to subsequent exposure to the sun. Skin lesions usually develop within 24-48 hours and are represented by erythema, blistering, itching or pain, followed by prolonged hyperpigmentation. Furocoumarins can be linear, like 8-methoxypsoralen (8-MOP), or angular, like angelicin or pimpinellin. By binding to the DNA molecule, these substances cause damage to them. Such reactions can develop in flower growers, gardeners, farmers, summer residents, catering workers and botanists. The authors of the article emphasize that most often photophytodermatitis occurs after contact with plants of the Umbelliferae family, the Rutaceae, Legumes and Mulberry families.

M. Sforza et al. [2] described the case of a 42-year-old patient who was admitted to the burn unit after drinking fig leaf tea and further insolation. Photophytodermatitis was caused by psoralen contained in the leaves of the plant. It should be noted that the fig tree belongs to the Mulberry family.

M. Nakamura et al. [3] continued the Kerr and Lim study comparing the incidence of photophytodermatitis among people of different races and skin types (comparing the incidence of the disease among blacks and Caucasians in the same institution over an 8-year period). The authors examined 229patients diagnosed with photophytodermatitis. Among them, 138 (46.6%) people were African Americans, and 63 (42.2%) were Caucasians. Statistically significant differences in the distribution of dermatosis among representatives of the Negroid and Caucasian races are as follows: phototoxic reactions after taking drugs developed in 0.7 and 15.9%, respectively ( p <0.0001), photophytodermatitis - 0 and 6. 3% respectively ( p = 0.009), polymorphic photodermatosis (PMLE) – 86.2 and 54% ( p <0.0001) and porphyria - 0 and 7.9% respectively ( p = 0.003).

Thus, the incidence of photodermatitis on the skin of people belonging to the Caucasian race is the same as compared to that of the Negroid race. However, polymorphic photodermatosis is more common in African Americans, while porphyrias and phototoxic reactions after drug use are more common in Caucasians.

Most dermatologists are able to recognize the classic symptoms of plant contact dermatitis. However, few doctors know the names of plants or chemicals that cause irritation or an allergic reaction. D. Sasseville [4] identifies 5 main clinical varieties of phytodermatitis: allergic phytodermatitis, photophytodermatitis, irritant contact dermatitis, pharmacological irritants and mechanical damage. The author describes the chemical structure of substances that cause skin rashes, and also draws attention to the fact that at present the problem of photophytodermatitis is becoming more and more relevant due to fashion trends such as aromatherapy, herbal medicine and the so-called natural therapy, which uses natural extracts. from plants.

C. Schempp et al. [5] also emphasize that plant products are increasingly being used for medicinal and cosmetic purposes. Many cosmetic preparations contain herbal extracts as fragrances. Tea tree oil, arnica extract, chamomile, yarrow, citrus extracts, ivy, aloe, lavender, mint, etc. can have a sensitizing effect on the skin of varying severity. However, sesquiterpene lactones or terpenes have the greatest sensitizing potential. This article discusses various forms of phytodermatitis, including irritant dermatitis, phototoxic and photoallergic dermatitis, allergic dermatitis, and air contact dermatitis.

Mankind has always used plants to treat many ailments. This is due to the fact that plants have various active substances: flavonoids, alkaloids, essential oils, resins, and so on. Many representatives of the Ranunculaceae family ( Ranunculaceae ) can cause the development of photophytodermatitis on the skin. For example, sickle-shaped hornhead ( Ceratocephalus falcatus ) has medicinal properties and is used as a laxative, as well as for the treatment of hemorrhoids, rheumatic diseases and wound healing. However, this plant, like many members of this family, contains psoralen, so after contact with the skin, rashes can develop that correspond to the clinical picture of photophytodermatitis. M. Gönul et al. [6] described a clinical case in a 58-year-old female patient who used cornea crescent as a medicine: after its use, rashes developed on the skin, which were regarded by the authors as photophytodermatitis. S. Karaca et al. [7] described a case of the development of photophytodermatitis caused by the use of cornea falciformis to relieve pain in the knee. S. Akbulut et al. [8] described the clinical picture of photophytodermatitis caused by contact with the buttercup ( Ranunculus arvensis ). Patients used this plant to treat arthralgia and osteoarthritis. Eruptions occurred at the site of contact of the plant with the skin: in a 48-year-old man – on the skin of the thumb of his right hand, in a 70-year-old woman – on the front surface of both lower extremities in the area of ​​the knee joints, and in a 59-year-old woman – in the area of ​​the knee folds . In all 3 cases, field ranunculus ( Ranunculus arvensis ) was found to be the cause of photophytodermatitis. The authors in their article also presented a review of 25 cases of photophytodermatitis described in the literature, which developed after skin contact with a buttercup.

Serphorn Buttercup ( Ceratocephalus falcatus ) is a wild plant and belongs to the Buttercup family. This group of plants contains ranunculin glycoside, which has irritating properties. A. Metin et al. [9] described cases of phytodermatitis that developed after application of lotions with buttercup sicklehorn. The clinical picture resembled a second degree burn with hyperemia and bullous elements.

In the specialized literature, cases of the development of photophytodermatitis after skin contact with plants belonging to the Compositae family are described. So, S. Ghosh et al. [10] observed photophytodermatitis after contact with Parthenium hysterophorus belonging to the Compositae family. S. Davis et al. [11] examined 50 patients with suspected contact dermatitis caused by various plants and assessed provoking factors. 31 (62%) people complained of photosensitivity, 24 (48%) reported rashes on open areas of the body. Patients were patch tested with a standard range of allergens for India, tests with allergens of plants belonging to the local flora, as well as with allergens of those plants that the patient himself suspected. The patch test results were consistent with the clinical picture. Most patients with exposed phytodermatitis were in contact with plants of the legume family ( Leguminosae ).

In addition, we must not forget about occupational dermatoses, which are considered as any change in the skin, mucous membranes or skin appendages, directly or indirectly caused, maintained or aggravated by agents present in the patient’s occupational activities. O. Alchorne Ade et al. [12] studied photophytodermatitis as an occupational dermatosis. J. Derraik et al. [13] described two clinical cases of the development of photophytodermatitis in professional gardeners after contact with a plant of Grevillea large of the Proteus family in New Zealand. The authors emphasize the need to disseminate information about plants that can cause photophytodermatitis among the population.

R. Vereecken et al. [14] demonstrated the case of a 39-year-old patient, a gardener by profession, who developed erythematous bullous rashes on the skin on a sunny summer day. The patient was diagnosed with contact phototoxic phytodermatitis.

It is important to note that photophytodermatitis can also develop in children who play with plants. K. Wilken et al. [15] described a case of illness in a 6-year-old child, when, after contact with a member of the Euphorbiaceae family the day before ( Euphorbiaceae ) – milkweed sungazer – foci of linear hyperemia and vesicular elements appeared on the skin of the face. Euphorbia sungazer ( Euphorbia helioscopia ) secretes juice characteristic of this family, causing toxic reactions after contact with the skin and mucous membranes.

Several cases of phytodermatitis caused by plants of the family Euphorbiaeae have been described in the literature.

C. Schempp et al. [16] observed the development of bullous contact dermatitis on the skin of a patient after contact with fragrant rue (rutaceae family). Its components that cause a phototoxic reaction are furanocoumarin 5-methoxypsoralen (bergapten) and 8-methoxypsoralen (xanthotoxin), as well as furanoquinoline dictanim. The phototoxic properties of the latter were recently discovered. The grass of plants of the Rutovye family contains essential oils, vitamin C, tannins, furanocoumarins, alkaloids and the flavonoid glycoside rutin; traces of skimmiamin and cocusaginin were found in the fruits; the roots contain coumarin, furocoumarins and essential oil. A. Zobel et al. [17] described eight members of the Rutov family ( Rutaceae ) and Umbelliferae ( Umbelliferae ), which are known as the cause of photophytodermatitis. These plants contain linear furocoumarins – psoralen, bergapten and xanthotoxin – on the surface of the leaves at a concentration of 0. 014-1800 gmg/g fresh weight. In spring, the concentration of these substances in the leaves is higher than in autumn. It turned out that among the studied plants, fragrant rue ( Ruta graveolens ) had the highest concentration of all three furocoumarins.

A. Gregersen et al. [18] reported that the most common cause of photophytodermatitis in Germany are plants of the Umbelliferae family ( Apiaceae ), especially common hogweed ( Heracleum spondylium ). The authors described a case of the development of phytodermatitis after skin contact with the white ash tree ( Dictamnus alba ), or “punishing bush”, also known from the Bible as the burning bush. This plant belongs to the Root family.

M. Rademaker et al. [19] described 20 cases of phytodermatitis after skin contact with toxicodendron (juicy sumac, wax tree). Among the patients there were 8 females and 12 males; the age of children was under 15 years old, adults -35-45 years old. In children, rashes were noted on the skin of the face, which is associated with playing under this plant; in adult patients, rashes were most often localized on the skin of the upper extremities (they appeared when pruning branches). In 15 patients, rashes appeared in the period from March to May, in the rest – from December to February. Most patients needed systemic steroids for the treatment of phytodermatitis.

Sometimes the reaction to some plants is detected for the first time. So, H. Ozkol et al. [20] described rashes caused by skin contact with lanceolate plantain ( Plantago lanceolata ) belonging to the Plantain family ( Plantaginaceae ). Photophytodermatitis was caused by ingestion of the plant or skin contact with it, subject to subsequent exposure to the sun. The authors observed two such cases and described them as phototoxic reactions.

In the spring-summer period, many patients come to see a dermatologist with complaints of rashes that appeared after skin contact with certain plants. Most often, patients indicate precisely contact with common hogweed.

Common hogweed ( Heracleum spondylium ) belongs to the family Umbelliferae ( Umbelliferae ). The plant is one or two years old. The plant owes its Russian name to the fact that in the old days (XVI century), some types of this plant were used to make borscht, as they have a sour taste. Currently, some representatives of the hogweed are used as silage feed for livestock. The height of the stem is mainly about 50-70 cm, however, some species can reach up to 2 m in height. Hogweed ordinary has a hollow stem; leaves are large, large, dissected into several large lobes, covered with hard hairs; the flowers are small, white or white-pink, collected in complex umbrellas. At present, due to the deterioration of the ecological situation, the hogweed has spread widely in the wild, occupying wastelands and right of way. Some representatives of hogweed ( Pubescentia ) contain furocoumarins (bergapten, xanthotoxin and isopimpinellin) in the juice, which can cause symptoms of dermatosis if it comes into contact with the skin. This group of substances in hogweed is found in leaves and villi (Fig. 1) . Figure 1. Hogweed.

In the period from May to September 2013, 37 patients (25 women and 12 men) aged 18 to 66 years old applied to a dermatologist at the Varshavsky branch with complaints of skin rashes that appeared after contact with various plants. Rashes were noted on the skin of exposed areas of the body. Clinical picture (Fig. 2) was represented by foci of hyperemia, sometimes of a linear form, vesicles and bullous elements with serous or serous-hemorrhagic contents. Figure 2. Development of photophytodermatitis in patient N. after contact with the plant. The lid of the blisters ruptures, exposing slowly epithelializing erosions. It is important to note that rashes appeared in the period from several hours to several days after the juice got on the skin. In addition, the symptoms manifested regardless of whether contact with the plant occurred on a sunny or cloudy day. The process of epithelialization after contact of the skin with the juice of common hogweed proceeded slowly. After the resolution of the pathological process, hyperpigmentation persisted for a long time. Subjectively, patients were disturbed by the feeling of itching, burning, soreness; 3 patients noted worsening of the general condition – headache, subfebrile temperature, nausea – within 1 day.

As therapy, patients received second-generation antihistamines (1 tablet at night for 10 days) and topical glucocorticosteroids (2 times a day for 7-14 days). A new preparation of betamethasone dipropionate Betliben (Jadran, Croatia) was used as a local glucocorticosteroid. Betliben is available as a 0.05% cream and ointment. The paraffin base of the product ensures easy application, fast absorption and no odor after application. Betliben is produced according to GMP quality standards, while it has an affordable price for most patients.

As an example, we present the case history of patient K. , 60 years old. Rashes on the hands and in the area of ​​the wrist joints (Fig. 3, a) arose after agricultural work (weeding beds with carrots and parsley). Figure 3. Clinical manifestations of photophytodermatitis in patient K. a – before treatment. The patient was prescribed second-generation antihistamines, 1 tablet at night for 10 days and cream Betliben (0.05% betamethasone dipropionate), applied 2 times a day for 7 days to the affected areas of the skin. After 7 days, the rash completely resolved. It is important to note that after the regression of the pathological process at the site of the rash for a long time (3-4 months), foci of hyperpigmentation (see Fig. 3, b) remain. Figure 3. Clinical manifestations of photophytodermatitis in patient K. b – after treatment .

Thus, the problem of photophytodermatitis is very urgent and requires special attention of dermatologists. It is necessary to carry out explanatory work among the population. In the treatment of photophytodermatitis, the correct use of modern preparations of topical glucocorticosteroids allows you to quickly achieve positive results.