[Irritant contact dermatitis caused by direct contact with oleander (Nerium oleander)].

Abstract

BACKGROUND:

Although the oleander plant is practically ubiquitous throughout the Mediterranean area, very few publications refer to its cutaneous toxicity.

PATIENTS AND METHODS:

Herein, we report two cases of irritant contact dermatitis caused by oleander. The patients in question were twins who had oleander leaves applied directly to their face for 20minutes. The initial lesions consisted of periorbital erythema, followed by the emergence of papules and macules. Vesicles and crusts appeared over the ensuing 24hours. Treatment included withdrawal of the toxic agent, prescription of oral antihistamines, and the topical application of dermocorticoids to the lesions for two weeks. The outcome on the 9th day was slightly hypochromic and atrophic. Complete restitutio ad integrum of the skin was observed after 30 days.

DISCUSSION:

In our patients, a joint effect of ultraviolet radiation (phytophotodermatitis) and chlorine from the swimming pool cannot be ruled out. Although the substances present in oleanders (irritant saponins and glycosides) can cause chemical irritant dermatitis, immunological reactions cannot be excluded. The lack of signs of systemic toxicity observed is the result of the factors governing transdermal diffusion of the toxic glycosides found in oleander.

CONCLUSION:

These two cases provide a timely reminder, both for the general public and for healthcare professionals, of the potential biohazards of oleander, not only because of its systemic toxicity but also because of the risks associated with cutaneous exposure.

• Authors: G Pellet, M Masson-Regnault, M Beylot-Barry, M Labadie
• Journal: Annales de dermatologie et de venereologie (Ann Dermatol Venereol) 2015 Jun-Jul Vol. 142 Issue 6-7 Pg. 434-7 ISSN: 0151-9638 [Print] France
• Vernacular Title: Dermatite irritative par contact direct avec du laurier rose (Nerium oleander).
• PMID: 25999263 (Publication Type: Case Reports, English Abstract, Journal Article)
• Copyright: Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Chemical References

• Glycosides
• Irritants
• Saponins

Topics

• Adolescent
• Blister (etiology)
• Dermatitis, Contact (etiology)
• Diseases in Twins (etiology)
• Facial Dermatoses (etiology)
• Female
• Glycosides (pharmacokinetics, toxicity)
• Halogenation
• Humans
• Irritants (toxicity)
• Male
• Nerium (toxicity)
• Plant Leaves (toxicity)
• Plants, Toxic (toxicity)
• Saponins (pharmacokinetics, toxicity)
• Skin Absorption
• Swimming Pools
• Ultraviolet Rays (adverse effects)