Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter to the Editor
2010:76:3;286-287
doi: 10.4103/0378-6323.62978
PMID: 20445305

Contact dermatitis to parthenium simulating lichen nitidus

Dipankar De, Rashmi Jindal, Amrinder J Kanwar
 Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Amrinder J Kanwar
Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
How to cite this article:
De D, Jindal R, Kanwar AJ. Contact dermatitis to parthenium simulating lichen nitidus. Indian J Dermatol Venereol Leprol 2010;76:286-287
Copyright: (C)2010 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

A 20-year-old male manual laborer sought dermatology consultation for itchy minimally red eruptions over dorsum of hands, elbows and feet, present for 2.5 years. The lesions started appearing on dorsum of hands and then progressed to other areas. They were itchy and non-oozy. There was no history of seasonal variation in severity of disease. He gave history of aggravation after work with cement, farming and exposure to sun. There was no personal or family history of atopy. On cutaneous examination, there were multiple well defined, discrete flat topped erythematous to skin colored papules with a shiny surface and the lesions were arranged in clusters [Figure - 1]. No lesion was present elsewhere including genitalia. Previous use of topical steroids, antihistamines and emollients was of some help. Based on the morphology of lesions, provisional diagnosis of lichen nitidus, polymorphous light eruptions and contact dermatitis was considered. A biopsy specimen was obtained from one of the papules, which on histopathological examination revealed hyperkeratosis, spongiosis and lymphocytic dermal infiltrate consistent with spongiotic dermatitis [Figure - 2]. Patch test was done with Indian standard series and plant antigens including parthenium. The patch test was positive for cobalt (±) and parthenium (++) on day 2 and day 4 [Figure - 3] according to the International Contact Dermatitis Research Group Criteria. Considering his occupation, we reached a diagnosis of contact dermatitis to parthenium. Temporary change in occupation along with a short course of oral prednisolone 40 mg/day, topical steroids (clobetasol propionate 0.05%), antihistamines and photo protection led to substantial recovery after four weeks of therapy.

Parthenium hysterophorous, a member of the family compositae, is an exotic weed introduced accidentally in India in 1956 through imported wheat. Characteristically, parthenium causes air borne contact dermatitis (ABCD) which starts from the exposed sites of face, neck and flexures with erythema, papules, occasional blistering and intense pruritus resulting later in skin thickening, hyperpigmentation and development of leonine facies. Apart from ABCD, other patterns of manifestation are photodermatitis, atopic dermatitis, seborrheic dermatitis and photosensitive lichenoid dermatitis. [1]

Hand dermatitis as a pattern of parthenium dermatitis has also been recorded especially in gardeners after contact with the weed. [2] Such wide varieties of patterns cannot be explained only on the basis of delayed type IV hypersensitivity. Therefore, combined type I and IV hypersensitivity to parthenium has been recently postulated. In case of atopic, Type I hypersensitivity mediated by IgE antibody is thought to initiate and perpetuate the dermatitis. [3] Parthenium hysterophorous may precipitate or exacerbate the atopic dermatitis which presents with photo aggravation, heat intolerance and flexural involvement. In atopics, apart from the usual patterns of parthenium induced dermatitis, prurigo nodularis and chronic actinic dermatitis can be observed. [4],[5] The morphology of lesions in our patient resembled lichen nitidus, which was excluded by histopathological examination and patch test. In case of non-eczematous contact dermatitis patch test reaction patterns are more often eczematous as was seen in our patient. It is important to consider a diagnosis of parthenium dermatitis in every patient who has occupational exposure to parthenium and present with eruptions in exposed parts of the body. This is imperative because parthenium contact dermatitis presents with widely variable morphology. Diagnosis should be substantiated by histopathology and patch test.

References
1.
Shenoi SD, Srinivas CR. Changing clinical patterns of parthenium dermatitis. Contact Dermatitis 1997;37:128.
[Google Scholar]
2.
Warshaw EM, Zug KA. Sesquiterpene lactone allergy. Am J Contact Dermat 1996;7:1-23.
[Google Scholar]
3.
Lakshmi C, Srinivas CR. Type I hypersensitivity to Parthenium hysterophorus in patients with parthenium dermatitis. Indian J Dermatol Venereol Leprol 2007;73:103-5.
[Google Scholar]
4.
Uehara M. Prurigo reaction in atopic dermatitis. Acta Derm Venereol (Stockh) 1980;92:109-10.
[Google Scholar]
5.
Russell SC, Dawe RS, Collins P, Man I, Ferguson J. Photosensitivity dermatitis and the actinic reticuloid syndrome (chronic actinic dermatitis) occurring in seven young atopic dermatitis patients. Br J Dermatol 1998;138:496-501.
[Google Scholar]

Fulltext Views
1,977

PDF downloads
1,338
Show Sections