Case and Research Letter
Airborne Allergic Contact Dermatitis Caused by Neem Oil
Dermatitis de contacto alérgica aerotransportada por aceite de neem
A. Sánchez-Gilo
, A. Nuño González, M. Gutiérrez Pascual, F.J. Vicente Martín
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Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
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Sánchez-Gilo, A. Nuño González, M. Gutiérrez Pascual, F.J. Vicente Martín" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Sánchez-Gilo" "email" => array:1 [ 0 => "aracelisanchezg@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Nuño González" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Gutiérrez Pascual" ] 3 => array:2 [ "nombre" => "F.J." "apellidos" => "Vicente Martín" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatitis de contacto alérgica aerotransportada por aceite de neem" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 900 "Ancho" => 1200 "Tamanyo" => 133798 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Neem oil. B, Patch test results at 96<span class="elsevierStyleHsp" style=""></span>h for neem oil (+++). C, Patch test results at 96<span class="elsevierStyleHsp" style=""></span>h for dilutions at 25% and 50%.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The incidence of allergic contact dermatitis to essential oils is rising as these compounds are found in a wide range of products.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> They are a common ingredient in cosmetic products, together with fragrances, and sensitization to both is common.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> Sensitization to essential oils and fragrances can be accurately diagnosed by patch testing with fragrance markers from the standard series of allergens of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), markers from specific allergen series, and products brought in by the patient.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> A 58-year-old man with a history of psoriasis being treated with topical corticosteroids and emollients presented with edema and erythema on both eyelids that had appeared 24<span class="elsevierStyleHsp" style=""></span>hours after fumigating a vegetable plot with a homemade fumigation mix. The cutaneous manifestations disappeared with the application of topical clobetasol propionate. The fumigation mix contained pure neem oil bought from an online distributor (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient reported that he had used neem oil as an emollient for psoriasis plaques in the past. The plaques disappeared, but the man developed eczematous lesions after repeated applications and decided to stop using the oil. The lesions cleared when he did this. We performed patch tests with the GEIDAC standard series, the Chemotechnique Diagnostics Fragrance Series, limonene hydroperoxide, linalool, and neem oil (brought in by the patient). Readings at 48 and 96<span class="elsevierStyleHsp" style=""></span>hours were positive for nickel (++) and neem oil (+++) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). Dilutions at 25% and 50% were also positive at 48 and 96<span class="elsevierStyleHsp" style=""></span>hours (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). The same tests in 16 controls were negative. The patient applied neem oil to his forearm and developed an eczematous reaction at the application site and on both eyelids at 48<span class="elsevierStyleHsp" style=""></span>hours. Based on these findings, we established a diagnosis of airborne allergic contact dermatitis to neem oil in a patient who had already exhibited manifestations of allergic contact dermatitis to the same substance. Neem oil is extracted from the seeds of the neem tree (<span class="elsevierStyleItalic">Azadirachta indica</span>), which is native to India and has been widely used in Hindu medicine for years. The neem tree has anti-infective, immunomodulatory, anti-inflammatory, antioxidant, and anticarcinogenic properties and has been used to treat many systemic and dermatological diseases, including alopecia, ulcers, leprosy, acne, psoriasis, eczema, ringworm, warts, and radiodermatitis.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">4,5</span></a> It is also used in cosmetic products, pesticides, fungicides, insect repellents, and fertilizers.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Just 4 cases of contact dermatitis to neem oil have been reported and they have all involved different diseases treated topically. Two of the patients had psoriasis<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7,8</span></a> (like our patient), 1 had alopecia areata,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> and 1 had a boil.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> In the cases described by Greenblatt et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> and Lauriola and Corrazza,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> the same tests performed in 5 and 8 controls, respectively, were negative. Only one of the studies cited, that of Hamamoto, tested diluted forms and these were positive.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> Two of the patients tested positive to other fragrances (fragrance mix I and other essential oils contained in the patients’ own products).<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">6,8</span></a> Our patient only tested positive to neem oil. The allergen in neem oil is unknown as over 140 components have been isolated.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> Of these, triterpenoids (azadirachtin and nimbin), coumarins, contaminants, and oxidation subproducts all have allergenic potential. Components may also be altered during the oil extraction process. Products with a high concentration of azadirachtin are potent pesticides but they can also act as irritants. It is therefore important to perform a complete study with dilutions and controls to rule out irritant contact dermatitis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> The current case highlights the importance of thoroughly questioning patients with suspected allergic contact dermatitis. It is important to obtain information about the products the patients are exposed to in different areas of their lives, including hobbies and the use of alternative treatments, perhaps even for another condition.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez-Gilo A, Nuño González A, Gutiérrez Pascual M, Vicente Martín FJ. Dermatitis de contacto alérgica aerotransportada por aceite de neem. Actas Dermosifiliogr. 2018;109:449–450.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 900 "Ancho" => 1200 "Tamanyo" => 133798 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Neem oil. B, Patch test results at 96<span class="elsevierStyleHsp" style=""></span>h for neem oil (+++). C, Patch test results at 96<span class="elsevierStyleHsp" style=""></span>h for dilutions at 25% and 50%.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Essential oils, part I: Introduction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C. de Groot" 1 => "E. Schmidt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DER.0000000000000175" "Revista" => array:6 [ "tituloSerie" => "Dermatitis" "fecha" => "2016" "volumen" => "27" "paginaInicial" => "39" "paginaFinal" => "42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26983089" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contact allergy to essential oils cannot always be predicted from allergy to fragrance markers in the baseline series" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.A. Sabroe" 1 => "C.R. Holden" 2 => "D.J. Gawkrodger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cod.12528" "Revista" => array:7 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "2016" "volumen" => "74" "paginaInicial" => "236" "paginaFinal" => "241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26806578" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2215036615000516" "estado" => "S300" "issn" => "22150366" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic contact dermatitis to fragances: Part 2" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.P. Arribas" 1 => "P. Soro" 2 => "J.F. Silvestre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2012.03.005" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2013" "volumen" => "104" "paginaInicial" => "29" "paginaFinal" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22770503" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neem <span class="elsevierStyleItalic">(Azadirachta indica):</span> Prehistory to contemporary medicinal uses to humankind" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.S. Kumar" 1 => "V. Navaratman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2221-1691(13)60105-7" "Revista" => array:6 [ "tituloSerie" => "Asian Pac J Trop Biomed" "fecha" => "2013" "volumen" => "3" "paginaInicial" => "505" "paginaFinal" => "551" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23835719" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypericum perforatum and neem oil for the management of acute skin toxicity in head and neck cancer patients undergoing radiation or chemo-radiation: A single-arm prospective observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Franco" 1 => "I. Potenza" 2 => "F. Moretto" 3 => "M. Segantin" 4 => "M. Grosso" 5 => "A. Lombardo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13014-014-0297-0" "Revista" => array:5 [ "tituloSerie" => "Radiat Oncol" "fecha" => "2014" "volumen" => "9" "paginaInicial" => "297" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25544371" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neem oil: An herbal therapy for alopecia causes dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Reutemann" 1 => "A. Ehrlich" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatitis" "fecha" => "2008" "volumen" => "19" "paginaInicial" => "E12" "paginaFinal" => "E15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18627678" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic contact dermatitis caused by neem oil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.T. Greenblatt" 1 => "P. Banerjee" 2 => "J.M. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 83 | 9 | 92 |
| 2024 Octubre | 574 | 48 | 622 |
| 2024 Septiembre | 664 | 63 | 727 |
| 2024 Agosto | 653 | 82 | 735 |
| 2024 Julio | 778 | 49 | 827 |
| 2024 Junio | 561 | 45 | 606 |
| 2024 Mayo | 551 | 51 | 602 |
| 2024 Abril | 450 | 45 | 495 |
| 2024 Marzo | 425 | 36 | 461 |
| 2024 Febrero | 497 | 54 | 551 |
| 2024 Enero | 478 | 45 | 523 |
| 2023 Diciembre | 568 | 40 | 608 |
| 2023 Noviembre | 517 | 25 | 542 |
| 2023 Octubre | 526 | 25 | 551 |
| 2023 Septiembre | 553 | 33 | 586 |
| 2023 Agosto | 502 | 19 | 521 |
| 2023 Julio | 436 | 26 | 462 |
| 2023 Junio | 367 | 26 | 393 |
| 2023 Mayo | 382 | 34 | 416 |
| 2023 Abril | 321 | 24 | 345 |
| 2023 Marzo | 376 | 30 | 406 |
| 2023 Febrero | 324 | 25 | 349 |
| 2023 Enero | 257 | 37 | 294 |
| 2022 Diciembre | 213 | 50 | 263 |
| 2022 Noviembre | 126 | 43 | 169 |
| 2022 Octubre | 110 | 33 | 143 |
| 2022 Septiembre | 160 | 45 | 205 |
| 2022 Agosto | 103 | 35 | 138 |
| 2022 Julio | 89 | 38 | 127 |
| 2022 Junio | 81 | 33 | 114 |
| 2022 Mayo | 232 | 49 | 281 |
| 2022 Abril | 305 | 46 | 351 |
| 2022 Marzo | 288 | 61 | 349 |
| 2022 Febrero | 275 | 32 | 307 |
| 2022 Enero | 226 | 47 | 273 |
| 2021 Diciembre | 198 | 47 | 245 |
| 2021 Noviembre | 217 | 54 | 271 |
| 2021 Octubre | 286 | 68 | 354 |
| 2021 Septiembre | 239 | 44 | 283 |
| 2021 Agosto | 259 | 38 | 297 |
| 2021 Julio | 245 | 34 | 279 |
| 2021 Junio | 354 | 37 | 391 |
| 2021 Mayo | 289 | 32 | 321 |
| 2021 Abril | 510 | 63 | 573 |
| 2021 Marzo | 301 | 24 | 325 |
| 2021 Febrero | 198 | 26 | 224 |
| 2021 Enero | 151 | 20 | 171 |
| 2020 Diciembre | 150 | 14 | 164 |
| 2020 Noviembre | 150 | 26 | 176 |
| 2020 Octubre | 158 | 13 | 171 |
| 2020 Septiembre | 155 | 13 | 168 |
| 2020 Agosto | 176 | 20 | 196 |
| 2020 Julio | 156 | 15 | 171 |
| 2020 Junio | 96 | 28 | 124 |
| 2020 Mayo | 61 | 22 | 83 |
| 2020 Abril | 53 | 20 | 73 |
| 2020 Marzo | 30 | 19 | 49 |
| 2020 Febrero | 5 | 0 | 5 |
| 2020 Enero | 2 | 0 | 2 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 2 | 0 | 2 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 6 | 10 |
| 2019 Mayo | 6 | 6 | 12 |
| 2019 Abril | 2 | 0 | 2 |
| 2019 Marzo | 2 | 0 | 2 |
| 2018 Diciembre | 4 | 0 | 4 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Junio | 0 | 1 | 1 |
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