Botanical Dermatology

Botanical Dermatology : 

Botanical Dermatology Prof. (Dr) Chakra Pany Sharma Ph D, M D (Ayu) Professor & Head Department of Dravyaguna Vigyan (Herbology & Pharmacology) Rajasthan Ayurveda University Jodhpur-India Email: chayaka2003@yahoo.com chakrapany2006@yahoo.co.in

Introduction to systemic botany, the organizing and naming of plants : 

Introduction to systemic botany, the organizing and naming of plants Plant names seem to keep changing. Why are the Umbelliferae also known as the Apiaceae or the Compositae known as Asteraceae? Is poison ivy a member of the genus Rhus or not? The original two kingdoms of Animals and Plants have expanded to five recognized kingdoms (Animalia, Plantae, Fungi, Protista, and Monera). "Plant Dermatitis" now includes reactions to organisms in three of the five kingdoms. This chapter focuses on responses within the Kingdom Plantae.

Contd…………………: 

Contd………………… Systematic botany has two goals; one is to describe the world's flora by classifying them in a hierarchy of similarity ( taxonomy ), and the other is to provide referable handles for these entities so that they may be referred to accurately ( nomenclature). Taxonomy utilizes information from numerous sources, including many techniques of analysis and synthesis. As scientific study progresses, the understanding of natural relationships grows, and the categorization of plants continually changes. Plant nomenclature, on the other hand, is a quasi-legal scheme that is based upon the "International Code of Botanical Nomenclature" (ICBN) which is maintained by a body called the International Association of Plant Taxonomy (IAPT) . The ICBN has been codifying the procedures for applying referable names to plants since 1867.

Binomial nomenclature : 

Binomial nomenclature Carl Linnaeus The general stability of plant nomenclature derives from the seminal works of the 18th century Swedish naturalist, Carl Linnaeus (1707-1778) who introduced the consistent use of "binomial nomenclature” in a series of works, but most significantly in the two-volume first edition of Species plantarum (1753). The nomenclatural scheme is sometimes called "Linnaean" nomenclature.

All in the family: 

All in the family Family names are largely stable, but a few large and widespread families have alternative names, e.g., Asteraceae (the sunflower family) is alternatively known as Compositae; Lamiaceae (the mint family) and Brassicaceae (the mustard family) are known respectively as Labiatae and Cruciferae. Their alternative names were used in antiquity, and the ICBN permits their use in formal botany as a concession to ancient tradition. Four more families complete the list of seven families granted this indulgence by the IAPT: Palmae (Arecaceae, the palm family), Gramineae (Poaceae, the grass family), Leguminosae (Fabaceae, the pea family), and Umbelliferae (Apiaceae, the parsnip family).

Contact Dermatitis, Primary Irritant Type : 

Contact Dermatitis, Primary Irritant Type This is generally found in men who clean grease off their hands, using either methylated spirit or a detergent or trichloroethylene parts cleaner, in mechanics who use other strong primary irritant chemicals, and in housewives who use detergents.

IRRITANT DERMATITIS : 

IRRITANT DERMATITIS Irritant dermatitis can affect virtually anyone depending on the person's skin barrier function and the potency and duration of the irritant stimulus. Irritant dermatitis ranges from mild erythema to hemorrhagic bullae and necrosis. After several episodes of irritation, a person is often at risk for allergic sensitization. Mechanical irritation accounts for the majority of unpleasant reactions due to plant exposure.

MECHANICAL DERMATITIS : 

MECHANICAL DERMATITIS Skin penetration by macroscopic spines or thorns causes a papular irritant reaction that may resemble scabies or fiberglass dermatitis. Trichomes or glochids (in cacti) are hairy outgrowths of single cells or small groups of cells that often cause even more severe reactions than the larger thorns. Damage is caused by actual physical penetration into the skin. As with the urticating plants, irritant hairs and thorns defend against plant-eaters.

Contd…………………: 

Contd………………… Many plant families have been implicated. A recent article reviewed many Australian plants that cause mechanical dermatitis. Common ivy ( Hedera helix , Araliaceae) possesses many leaf-borne stellate hairs that readily detach as the leaves age. Some members of the family Compositae possess prominent irritating appendages such as thistles (multiple genera) and prickly lettuce ( Lactuca serriola ). Members of the Boraginaceae contain stiff, sharp hairs on the leaves and stems: borage ( Borago officianalis ), Amsinckia spp., and Echium spp. Rose hips (the fruit of roses) in members of the family Rosaceae possess irritant hairs used in itching powders .

Common causes of mechanical plant dermatitis : 

Common causes of mechanical plant dermatitis Family Genus Species Notes

Cacti: 

Cacti Of course members of the family Cactaceae are the most infamous irritants. While cacti possess large spines, the smaller glochids cause more notorious dermatologic problems. Glochids are stiff, barely visible, hairs that grow in tufts on the areolae of cactus pads. They possess self-retaining barbs that make extraction from the skin difficult.

Contd………………….: 

Contd…………………. As an example, Opuntia microdasys ('Polka Dot cactus'), a house and garden favorite, bears disarmingly-appearing fluffy clusters of 100-200 glochids on each of their pads. The related 'Beaver-tail cactus' ( Opuntia basilaris ) grows naturally in the Mojave and Colorado deserts.

'Sabra dermatitis' : 

'Sabra dermatitis' Prickly pears, including the species Opuntia ficus-indica (the Indian or Barbary fig), causes 'Sabra dermatitis'. This pruritic, papular eruption occurs among prickly pear pickers and those who unwarily stumble into burglar-proof hedges of this native Mexican plant. The fruit contains the highest concentration of glochids and is a staple part of the diet in the Middle East where the eruption is easily confused with scabies. 'Sabra' is from the Hebrew word for 'Native of Israel' and is also colloquially applied to the fruit.

‘Goose-grass' Dermatitis : 

‘Goose-grass' Dermatitis A notorious member of the family Rubiaceae ( Galium aparine ) causes 'goose-grass' dermatitis due to the hooked prickles on the fruit, stems, and leaves (Figure 4). The prickles attach fruits (containing seeds) to animals, thus naturally increasing the range of the plant. Galium aparine (Catchweed bedstraw). Note the hooked prickles on the fruit, stems, and leaves. While mechanical irritants to man, they help the plant expand its range.

Contd……………………..: 

Contd…………………….. Members of the family Moraceae include figs ( Ficus spp.) and mulberries ( Morus spp.). Numerous fine, abrasive bristles cover the leaves and fruit of certain species. 15 Many true grasses of the family Poaceae (Gramineae) possess fine hairs, prickly spikes, and even cutting leaf edges. Australian natives of the family Proteaceae, Genus Grevillea possess terminal, sharp points on their leaves that cause a prickling sensation on contact, as during pruning.

Contd…………………: 

Contd………………… While buttercups of the family Ranunculaceae are remembered more for their irritating chemicals, they also possess fine bristles. Coarse fibers on tulip bulb tunics (tecta) cause the irritant component of 'tulip fingers.' This reaction to tulip bulbs (genus Tulipa , Liliaceae) is primarily an allergic contact dermatitis. Ranunculus adoneuss (buttercup)

Contd………………: 

Contd……………… Of course, the well-known rose (Family Rosaceae, Genus Rosa ) can cause penetrating injuries. All thorns can cause foreign body granulomata if a portion remains in the skin. Thorns can cause even more severe reactions such as tenosynovitis, chronic arthritis, and exuberant periosteal reactions if implanted deeper into bones and joints. Rosa Rose bud with fruit (rose hip).The rose hip contains irritating hairs and high concentrations of vitamin C. Rose hips may be found on rose bushes year round.

Contd………………….: 

Contd…………………. Verbascum thapsus (Family Scrophulariaceae), commonly known as 'mullein' or 'flannel-plant', grows throughout the central plains of the United States, but it was introduced from Eurasia. The woolly hairs on leaves have been used cosmetically for their rubefacient effects.

Contd………………………………: 

Contd……………………………… Members of religious groups that forbade the use of cosmetics rubbed their upper cheeks with the leaves to create an erythematous glow. In Ancient times, the Romans used the plants bundled together as torches. Verbascum thapsus

Inoculation of microorganisms: 

Inoculation of microorganisms Clostridium tetani can be introduced by spines and thorns, Staphylococcus aureus by blackthorn injury ( Prunus spinosus , Rosaceae), and Sporothrix schenckii by grasses, sphagnum moss, and rose thorns. Atypical mycobacteria such as Mycobacterium kansasii (blackberries), M. marinum (cactus spines), and M. ulcerans (spiky tropical vegetation) can also be unwanted plant hitch-hikers that add infectious insult to injury .

Treatment: 

Treatment Many intriguing methods of removing glochids have been recommended. Warm wax, glue, sticking plaster, or cellophane tape is applied to the affected area. Then, the glochids are quickly ripped off. Facial gels and masks have been used similarly. In perhaps the only controlled study (in rabbits), glochids (of Opuntia ficus-indica ) were most effectively removed by first removing the larger clumps with tweezers and then applying glue to the affected area with gauze on top. After the glue dried, the gauze was grasped and peeled off. This resulted in removal of 95% of implanted spines.

CHEMICAL IRRITANT DERMATITIS -Through Plants: 

CHEMICAL IRRITANT DERMATITIS -Through Plants Several major plant families contain chemical irritants. These include crystalline calcium oxalate and a wide range of chemicals dissolved or suspended in plant latex or specific organelles. Some of the more important families with example plants causing chemical irritation are found.

Contd…………………..: 

Contd………………….. Calcium oxalate has been found in members of at least 215 plant families. It may be found in any part of the plant in varying concentrations. Cacti can accumulate huge quantities, such as Cephalocereus senilis that contains up to 85% ash weight calcium oxalate! Crystals of calcium oxalate form within plant cells and may aid ionic balance, help remove excess oxalic acid, or protect the plant against foraging animals. While calcium oxalate alone can cause irritant dermatitis, it is probably not the sole irritant in plants containing it.

Contd…………………: 

Contd………………… The prototypical calcium oxalate-containing plant is Dieffenbachia picta (Araceae) (Dumb cane, Mother-in-law's tongue). Millions decorate American homes. Common, related plants include Philodendron spp. (Araceae), and rhubarb, Rheum rhaponticum , (Polygonaceae). 'Dumb cane' received its name because chewing the leaves can lead to salivation, burning, mucosal edema, and blisters causing hoarseness or aphonia. Calcium oxalate, a water insoluble salt, is ejected from the plant when exposed to water, as in the skin or mucosa. Dieffenbachia picta, "Dumb cane"

Bulb dermatitis : 

Bulb dermatitis Bulb dermatitis is less dramatic but more common. Hyacinth, Hyacinthus orientalis (Liliaceae), bulbs contain up to 6% calcium oxalate. Sap from daffodil, Narcissus spp. (Amaryllidaceae), stems causes one of the most common dermatitis in florists, 'daffodil itch.' Dryness, fissures, scaling, and erythema chiefly affect the fingertips, hands, and forearms and are often accompanied by subungual hyperkeratosis.

Contd…………………..: 

Contd………………….. Calcium oxalate can enhance the irritancy of other chemicals, such as the proteolytic enzyme bromelin found in pineapples, Ananas comosus (Bromeliaceae), by increasing penetration through the stratum corneum. Pineapple workers often develop cracks, fissures, loss of fingerprints, and microhemorrhages of their hands resulting from juice contact. After the calcium oxalate causes microabrasions, the bromelin exerts its proteolytic effect on dermal blood vessels.

Contd…………………..: 

Contd………………….. Treatment of calcium oxalate ingestion includes parenteral steroids, antacid mouthwashes, and analgesics. Antihistamines are of no benefit. The pain and edema diminish over four to twelve days. Ananas comosus , variegated pineapple

Erythema and Blisters. : 

Erythema and Blisters. Many thiocyanates in the Brassicaceae, such as black mustard ( Brassica nigra) , horseradish ( Armoracia rusticana ), broccoli ( Brassica oleracea v. italica ), and radish ( Raphanus sativus ), cause a spicy taste due to irritant thiocyanates. 'Plasters' made from the plant oils have been used medicinally for years. Unfortunately, prolonged contact causes erythema and blisters. Armoracia rusticana, Horseradish

Contd………………..: 

Contd……………….. The spurge family (Euphorbiaceae) is notorious for its highly irritant latex, but derives its common name from the purgative properties of its seeds (French 'epurger' - to purge). Latex is made by some seed-bearing plants and refers to the viscid, milky juice used to store hydrocarbons. Over 7000 species of the spurge family are found throughout the world, making it one of the largest families of flowering plants. In AD 50, Dioscorides mentioned seven species of Euphorbia as remedies for warts, calluses, and torpid ulcers of the scalp. It seems that wart treatments have advanced little in nearly 2000 years! E. esula (latex in stem) E. esula

Contd…………………: 

Contd………………… The irritant chemicals are found in the milky latex produced by laticifers (distinctive unicellular or multicellular tubes) in the stems, leaves, fruits, and other organs. The active chemicals are phorbol (tigliane polyol) esters, caustic diterpene compounds, and/or daphnane (tricyclic diterpenoid) esters; these can also act as cocarcinogens. The latex may cause a painful, blistering dermatitis and even temporary blindness.

Contd………………………….: 

Contd…………………………. Different members of this family possess widely variant irritancy potential and even variation among the chemicals comprising the latex. Nearly 2000 years ago, Dioscorides knew first-hand the irritancy of these plants, for in his instructions for mixing cathartic pills he advocated self-protection: E. esula (leafy spurge)

Allergic Contact Dermatitis. : 

Allergic Contact Dermatitis. The castor oil plant ( Ricinus communis ), another member of Euphorbiaceae that has strangely been called 'true croton' by some, is a very uncommon cause of allergic contact dermatitis. It is now recognized as a cause of chemical irritant dermatitis. Ricinus communis , Castor Bean Plant

Phytophototoxic Reactions : 

Phytophototoxic Reactions Members of the buttercup family (Ranunculaceae) contain the unsaturated lactone, protoanemonin, that is formed after injury to the plant by the breakdown of ranunculin, a glycoside. Contact with the skin causes severe vesiculation and linear streaks that may resemble phytophototoxic reactions. However, there is little or no hyperpigmentation following the immediate reaction. Because protoanemonin rapidly polymerizes to anemonin (a non-irritant), only freshly damaged plants cause a reaction. Buttercup leaves have long been used in Europe and elsewhere as vesicants. Native American Indians have used buttercup sap in an astringent ointment for hemorrhoids, in cold remedies, and to revive unconscious people.

Contd…………………: 

Contd………………… Capsaicin (8-methyl-N-vanillyl-6-nonenamide) and four of its naturally occurring derivatives contribute to the pungent taste of peppers. The effect of this chemical is so strong, that even when diluted to one part in 11 million of water, a pungent taste remains. These fat-soluble phenols comprise 0.02% of the fresh fruit's weight and 0.5-1.0% of the dried fruit's weight. Virtually all forms of chili peppers are members of the species Capsicum annuum (Solanaceae). Capiscum annum , Chili Pepper

Human Hand Syndrom: 

Human Hand Syndrom When applied to the skin, capsaicin depolarizes nerves leading to vasodilation, smooth muscle stimulation, glandular secretions, and sensory nerve activation. Because the nerves, and not the skin itself, are affected, dose-related cutaneous burning pain, irritation, and erythema, but not blistering ensue. The pain has been described as a dull ache, like a sunburn, or like an intense, radiating heat, throbbing and prickling, and also as the pain elicited after touching a hot burner. These symptoms are often delayed and may last hours to days. This problem, known by some as 'Hunan Hand Syndrome' especially occurs among those who prepare their own peppers for eating by roasting them and removing skins from large batches of peppers while they are still warm.

TREATMENT : 

TREATMENT A controlled study in New Mexico showed that the best home remedy for chili burns was hand-washing with soap and water followed immediately by one hour of immersion in vegetable oil. Cold water was more effective in the first hour of treatment, but it only helped symptoms for as long as involved body parts were immersed. The vegetable oil treated hands were less painful than the cold water treated hands more than one hour after immersion in chili pepper sauce . If available, lidocaine gel is anecdotally effective. Gloves should be worn while preparing chili peppers to minimize the risk of 'chili burns.' Medicinal uses of capsaicin include the treatment of post-herpetic neuralgia, diabetic neuropathy, and arthritis. It also serves as the active ingredient in self-defense sprays

OCCUPATIONAL PLANT DERMATOSES : 

OCCUPATIONAL PLANT DERMATOSES Occupational exposure to plants occurs in various professions, most commonly in florists, horticulturists, grocery store workers, and outdoor workers, especially farmers, loggers, and foresters. Of course, members of any profession in which workers contact plants may contract plant-induced dermatoses. Other commonly affected professions include gardeners, food handlers, pharmaceutical workers, and botanists.

Contd……………: 

Contd…………… In the United States, agriculture workers have the greatest incidence of occupational skin disease due to plants. They had a 35.9% annual prevalence of dermatitis. The manufacturing industry was second with a 14.8% annual prevalence. Half of these were due to non-cash plants, trees, and naturally occurring vegetation, and only 10% were due to contact with food products (fruits and vegetables) being harvested.

Plant Dermatitis - At a Glance: 

Plant Dermatitis - At a Glance FLORISTS: Two studies in the United States estimate an 8% point prevalence of hand dermatitis among retail florists . A study of four Italian floriculture centers found that 25% of 200 workers had mechanical irritant dermatitis, 12% irritant dermatitis from chemical agents, 8% had pseudophytodermatitis from pesticides, insecticides, and fungicides, and only 5% had allergic contact dermatitis to plants.

GROCERY STORE WORKERS: 

GROCERY STORE WORKERS Phytophotodermatitis from contact with celery seems to be the main cause of plant-related occupational dermatitis in grocery store workers. The risk for phytophotodermatitis increases based on two factors: amount of exposure to fresh produce (especially celery) and the use of tanning salons (UVA exposure). One study found that the prevalence ratio of phytophotodermatitis was 41 for those with both risk factors compared to those with neither risk factor.

OUTDOOR WORKERS: 

OUTDOOR WORKERS Among that diverse group of the work force who spend most of their time outdoors, poison ivy and poison oak ( Toxicodendron spp . ) are the main causes of occupational contact dermatitis. It is estimated that 0.11% of all workmen's compensation is due to poison ivy and poison oak dermatitis due to its significant effect on those in agriculture. Foresters, especially when fighting forest fires, have virtually no control over avoiding these plants. Up to 25% of firefighters may need to leave the fireline because of severe toxicodendron dermatitis.

Contd………………: 

Contd……………… Forestry workers often suffer from 'Woodcutter's Eczema,' an allergic reaction due to airborne sesquiterpene lactones in Frullania (liverworts) growing on tree trunks in the American and Canadian Pacific Northwest. In Portugal, Frullania and lichen dermatitis accounts for 12% of occupational dermatitis in outdoor workers. The dermatitis is worse in wet winter months. It presents in a pseudo-photo distribution involving the upper eyelids but sparing the submental area. This suggests dispersal of oleoresin by rainwater.

THANKS: 

THANKS