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11/24. Musk ambrette and chronic actinic dermatitis.

    A patient with persistent photosensitivity and positive photopatch tests to musk ambrette and an after-shave lotion is reported. Phototests showed extreme sensitivity to UV radiation, especially UVB. patch tests with the European Standard Series and some plant allergens were negative. histology showed a granulomatous reaction with epithelioid and giant cells in the dermis.
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ranking = 1
keywords = plant
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12/24. Accidental induction of photocontact allergy to heracleum laciniatum.

    Photocontact allergy to psoralens in heracleum laciniatum occurred in two persons volunteering for investigations into phototoxicity of plant homogenates and purified psoralens. Photoallergy was noted following the fifth exposure in case 1, and the sixth in case 2. Testing with diluted solutions demonstrated allergy to sphondin, isobergapten and pimpinellin.
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ranking = 1
keywords = plant
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13/24. Gas plant (dictamnus albus) phytophotodermatitis simulating poison ivy.

    A 48-year-old man presented with an itchy rash that resembled superficial burns or cane marks on his left forearm; similar lesions had appeared every summer for 5 years. Poison ivy dermatitis had been the initial diagnosis, but the patient knew that this plant was absent from his well tended garden. A visit to the garden revealed the gas plant dictamnus albus, and occlusive patch testing with leaf cuttings produced a reaction after the skin was exposed to sunlight. Gas plant phytophotodermatitis was diagnosed.
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ranking = 7
keywords = plant
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14/24. Phytophotodermatitis due to Ruta graveolens.

    We report phytophotodermatitis in a 5-year-old boy, his 6-year-old sister and his mother, evoked by their handling common rue (Ruta graveolens), a plant which contains psoralens. psoralens are photoactive chemicals which, when rubbed on the skin, react with sunlight to produce erythema, hyperpigmentation and blistering. Phytophotodermatitis is an uncommon cause of such ill-effects, in children.
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ranking = 1
keywords = plant
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15/24. Phototoxicity of heracleum laciniatum. case reports and experimental studies.

    Phytophotodermatitis from heracleum laciniatum is described in 2 typical cases. Experimental phytophotodermatitis was produced using homogenates from leaves of the plant and long-wave ultraviolet light. The homogenates of leaves produced strong phototoxic reactions. The minimal phototoxic erythema dose was determined to be lowest for abdominal and midback skin. The action spectrum for heracleum laciniatum homogenates applied topically was found to be in the range 315-375 nm with peak sensitivity at 330-335 nm.
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ranking = 1
keywords = plant
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16/24. Erythropoietic protoporphyria with hepatic cirrhosis.

    Cholestatic jaundice and rapidly deteriorating hepatic function developed in a 19-year-old man with a lifelong history of photosensitivity. Laboratory studies revealed the characteristic increased erythrocyte and fecal protoporphyrin levels of erythropoietic protoporphyria. Progressive hepatic failure was treated by orthotopic liver transplantation six months after the first clinical indication of hepatic dysfunction. Characteristic light microscopic, fluorescence microscopic, and electron microscopic findings of erythropoietic protoporphyria were present in skin and liver. Four weeks after liver transplantation, the patient died of disseminated candidiasis. At autopsy, the donor liver had no microscopic evidence of protoporphyrin accumulation, although tissue protoporphyrin levels were mildly elevated.
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ranking = 2
keywords = plant
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17/24. Plant dermatitis due to the Compositae (asteraceae) family.

    dermatitis due to members of the Compositae (asteraceae) family of plants has been reported for many years from several parts of the world. Nevertheless, it seems to be overlooked by many present-day clinicians, undoubtedly because clinically it mimics photodermatitis or an airborne contact dermatitis of nonplant origin. This clinical review summarizes the rich literature on the subject, emphasizes the remarkably consistent clinical picture, and updates for readers relevant advances in botanical biochemistry and clinical implications, as well as current methods for diagnosis, attempts at treatment, and concepts of pathogenesis. It is hoped that the review will focus needed attention on this syndrome and will enhance prospects for accurate diagnosis, as well as further investigations into treatment and prevention.
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ranking = 2
keywords = plant
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18/24. Autosomal recessive erythropoietic protoporphyria: a syndrome of severe photosensitivity and liver failure.

    Erythropoietic protoporphyria is caused by inherited deficiency of the haem synthetic enzyme ferrochelatase, and is characterized by lifelong photosensitivity. About 5% of patients also develop rapidly progressive liver failure. Inheritance is considered to be autosomal dominant, with transmission of a single ferrochelatase defect from one parent. We describe a family in which two siblings with protoporphyria suffered from severe photosensitivity and developed hepatic failure requiring liver transplantation. Their asymptomatic parents were heterozygous for distinct ferrochelatase gene mutations (exon 10 donor site a( 3)-->g and 1088T-->G). Both mutations disrupt splicing of the transcript and cause partial deficiency of ferrochelatase. The affected offspring were compound heterozygotes for these mutations. These patients suffered from an autosomal recessive form of protoporphyria characterized by severe photosensitivity and cholestatic liver disease in adolescence. We postulate that hepatic failure in erythropoietic protoporphyria may in some cases represent an autosomal recessive type of ferrochelatase deficiency distinct from the purely dermatological disorder. Studies of disease inheritance in families affected by protoporphyria may help identify those predisposed to develop severe liver complications, a distinction not currently possible.
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ranking = 1
keywords = plant
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19/24. Cutaneous porphyrialike photosensitivity after liver transplantation.

    BACKGROUND: Liver disease and cholestasis are often associated with abnormal coproporphyrin levels, but photosensitivity eruptions do not usually occur with these conditions. We present a case of a cutaneous porphyrialike photosensitivity in a liver transplant patient with only mildly elevated coproporphyrin levels. OBSERVATIONS: A 5-year-old girl developed a cutaneous porphyria cutanea tarda-like photosensitivity after liver transplantation for congenital biliary atresia. Her cutaneous eruption consisted of fluid-filled vesicles and crusted erosions involving her face and arms. These lesions eventually healed with atrophic scarring and milia. The patient was in a state of chronic hepatic rejection, but her serum and 24-hour urine specimens contained only mildly elevated levels of coproporphyrin. Results of histopathologic examination and direct immunofluorescence of a skin biopsy specimen resembled those of porphyria. CONCLUSIONS: Although clinically porphyria cutanea tarda was suspected, her porphyrin profile was not consistent with that diagnosis. liver transplantation has become relatively common, but porphyria cutanea tarda-like clinical and histopathologic findings associated with coproporphyrinemia in a liver transplant patient have not been reported to date.
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ranking = 8
keywords = plant
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20/24. Phytophotodermatitis: a visit to Margaritaville.

    Phytophotodermatitis is a phototoxic eruption following contact with photosensitizing compounds and long-wave ultraviolet light. The most common phototoxic compounds are the furocoumarins contained in a wide variety of plants, especially of the Umbelliferae, rutaceae, and Moracea families. Commonly occurring photosensitizing plants include citrus fruits such as limes and oranges and many vegetables, notably celery, parsnip, parsley, carrots, and dill.
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ranking = 2
keywords = plant
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