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Master's Thesis UNIVERSITY OF LJUBLJANA FACULTY OF PHARMACY DAMIJANA GREGORIČ MASTER’S THESIS UNIFORM MASTER’S STUDY OF PHARMACY Ljubljana, 2016 UNIVERSITY OF LJUBLJANA FACULTY OF PHARMACY DAMIJANA GREGORIČ ALERGIJSKI KONTAKTNI DERMATITIS TER DRUGE KOŽNE REAKCIJE, POVZROČENE OB STIKU Z RASTLINAMI Allergic contact dermatitis and other skin reactions caused by plants UNIFORM MASTER’S STUDY OF PHARMACY Ljubljana, 2016 My master thesis was written during my Erasmus exchange from March 2015 to July 2015 at Faculty of Pharmacy, Universidad de Granada, under the mentorship of prof. dr. Paloma Cariñanos González from department of Botany. In Slovenia was my supervision prof. dr. Samo Kreft. THANKS: I would sincerely like to thank my prof. dr. Paloma Cariñanos González, for all her patience and professional directions during my work. Also I would like to thank my mentor, prof. dr. Samo Kreft for final comments to finish this thesis. Zahvala gre tudi mojim staršem. Hvala za vašo potrpežljivost ter podporo pri pripravi na zagovor. STATEMENT: I declare that I have done this master thesis independently under supervision of prof. dr. Samo Kreft and co-supervision of prof. dr, Paloma Cariñanos González. Ljubljana, May 2016 Damijana Gregorič President of the Thesis defence committee: prof. dr. Stanislav Gobec, mag. farm Member of the Thesis defence committee: doc. dr. Pegi Ahlin Grabnar, mag. farm III TABLE OF CONTENTS LIST OF TABLES .................................................................................................................................. VI LIST OF APPENDIX.............................................................................................................................. VI ABSTRACT ......................................................................................................................................... VII KEYWORDS ...................................................................................................................................... VIII ABBREVIATIONS .............................................................................................................................. VIII POVZETEK .......................................................................................................................................... IX KLJUČNE BESEDE ............................................................................................................................... XI 1 INTRODUCTION .......................................................................................................................... 1 1.1 DERMATITIS AND OTHER SKIN REACTIONS ........................................................................ 1 1.1.1 ALLERGIC CONTACT DERMATITIS ............................................................................... 1 1.1.2 IRRITANT CONTACT DERMATITIS ............................................................................... 3 1.1.3 CONTACT URTICARIA .................................................................................................. 8 1.1.4 PHYTOPHOTODERMATITIS ......................................................................................... 8 2 WORK PLAN .............................................................................................................................. 10 3 MATERIALS AND METHODS ..................................................................................................... 11 4 RESULTS .................................................................................................................................... 12 4.1 ALLERGENS AND CHEMICAL COMPOUNDS ...................................................................... 12 4.2 MOST ALLERGENIC PLANTS FAMILIES .............................................................................. 15 4.2.1 Asteraceae or Compositae Family ............................................................................ 15 4.2.2 Jubulaceae Family .................................................................................................... 22 4.2.3 Liliaceae family ......................................................................................................... 22 4.2.4 Alstroemeriaceae Family .......................................................................................... 23 4.2.5 Anacardiaceae Family ............................................................................................... 24 4.2.6 Ginkgoaceae Family.................................................................................................. 27 4.2.7 Proteaceae Family .................................................................................................... 27 4.2.8 Primulaceae family ................................................................................................... 28 4.2.9 Rutaceae family ........................................................................................................ 29 4.2.10 Alliaceae family ........................................................................................................ 30 4.2.11 Cruciferae family (Brassicaceae) .............................................................................. 31 4.2.12 Capparaceae Family ................................................................................................. 32 4.2.13 Araliaceae family ...................................................................................................... 32 4.2.14 Apiaceae family (Umbelliferae) ................................................................................ 33 IV 4.2.15 Solanaceae family ..................................................................................................... 34 4.2.16 Lamiaceae family (Labiatae family) .......................................................................... 35 4.2.17 Moraceae family ....................................................................................................... 36 4.3 PATCH TESTING, MIXTURES ............................................................................................. 37 4.4 DISCUSSION ...................................................................................................................... 40 5 CONCLUSIONS .......................................................................................................................... 44 6 REFERENCES ............................................................................................................................. 45 7 APPENDIX ................................................................................................................................. 48 V LIST OF TABLES Table I: Common plants causing chemical and mechanical irritant contact dermatitis (2,7) ............................................................................................................................................... 4 Table II: Some examples of plants known to cause phytophotodermatitis (9, 17) ................ 9 Table III: Constituents of two commercial Compositae mixes (29) .................................... 37 Table IV: Distribution of positive reactions to the constituents of Compositae mix 6% pet. in 76 patients with positive reactions to the mix (29) .......................................................... 38 Table V: Results of distribution of positive reactions to the constituents Compositae mix 5% pet. (29) ......................................................................................................................... 38 Table VI: Allergens contained within the plant series (28) ................................................. 39 LIST OF PICTURES Picture 1: Number of plant families and their usage .......................................................... 41 Picture 2: Frequent plant families that cause ACD ............................................................ 42 Picture 3: Number of plant families and allergens ............................................................. 43 LIST OF APPENDIX Appendix 1: Plants responsible for causing allergic contact dermatitis in South Africa (6) 48 Appendix 2: An alphabetical list of plants that can cause urticarial responses (8) ............ 50 VI ABSTRACT Plants have been used since ancient times. Nowadays their popularity is increased, not only as a food or decorative plants but also as herbal medicines and natural cosmetic. Because of that, we are daily in touch with them and it is necessary to know, which are the most harmful plants and allergens and what reactions on the skin they can cause. Allergic contact dermatitis, irritant contact dermatitis, contact urticaria and phytophotodermatitis are the most typical cutaneous reactions among phytodermatitis. Our main purpose was to make a general overview of plants that can cause allergic skin reactions. We wanted to estimate which plant families are the most allergenic, which occupation are the most exposed to them and which are the possible allergens. We started our research on databases (Scopus, PubMed). Firstly we were searching after the most allergenic plant families. After that we focused on specific plants and case reports. According to the literature we can say that allergic contact dermatitis is mostly generated by Compositae, worldwide known plant family. Anacardiaceae are the next plant family in which we have found more case reports. These plants are found in South and North America, Asia and South Africa. Primulaceae family is also common cause of ACD. Its plants are popular ornamental plants. According to our review,
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