Verma Kaushal K, Sirka C S, Ramam M, Sharma V K
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Contact Dermatitis. 2002 May;46(5):286-9. doi: 10.1034/j.1600-0536.2002.460507.x.
Parthenium hysterophorus is the commonest cause of airborne contact dermatitis (ABCD) in India. The disease usually manifests as itchy erythematous, papular, papulovesicular and plaque lesions on exposed areas of the body. Rarely, however, the disease may present as actinic reticuloid or photocontact dermatitis. We have observed a different clinical variant of this disease where certain patients with Parthenium dermatitis have presented with discrete, flat, violaceous papules and plaques on exposed areas of the body closely simulating photosensitive lichenoid eruption. We had 8 patients, 6 males and 2 females between 30 and 62 years of age, with itchy, violaceous, papules and plaques on the face, neck, ears, upper chest and dorsa of the hands for 6 months to 6.5 years. Four of these patients had a history of improvement of the lesions up to 30% in winter and aggravation of lesions on exposure to sunlight. There was no personal or family history of atopy. Cutaneous examination in all patients revealed multiple flat, violaceous, mildly erythematous papules and plaques on the forehead, sides and nape of neck, ears, 'V' area of the chest, and extensor aspects of the forearms and hands. Skin biopsies from these lesions showed features of chronic non-specific dermatitis. Patch testing with standardized plant antigens showed a positive patch test reaction to Parthenium hysterophorus in all patients, with a titre of contact hypersensitivity (TCH) varying from undiluted to 1 : 100. We conclude that Parthenium dermatitis may occasionally present with lesions very similar to the lesions of photosensitive lichenoid eruption in morphology and distribution. This clinical presentation of Parthenium dermatitis needs to be recognized to avoid misdiagnosis.
银胶菊是印度空气传播性接触性皮炎（ABCD）最常见的病因。该病通常表现为身体暴露部位出现瘙痒性红斑、丘疹、丘疱疹和斑块状损害。然而，该病很少表现为光化性类网状皮炎或光接触性皮炎。我们观察到了这种疾病的一种不同临床变体，即某些银胶菊皮炎患者在身体暴露部位出现离散的、扁平的、紫罗兰色丘疹和斑块，酷似光敏性苔藓样疹。我们有8例患者，年龄在30至62岁之间，其中6例男性，2例女性，面部、颈部、耳部、上胸部和手背出现瘙痒性紫罗兰色丘疹和斑块6个月至6.5年。其中4例患者有皮损在冬季改善达30%，暴露于阳光下后皮损加重的病史。无特应性个人或家族史。所有患者的皮肤检查均显示前额、颈部两侧和项部、耳部、胸部“V”区以及前臂和手部伸侧有多个扁平、紫罗兰色、轻度红斑性丘疹和斑块。这些皮损的皮肤活检显示慢性非特异性皮炎的特征。用标准化植物抗原进行斑贴试验，所有患者对银胶菊均呈阳性斑贴试验反应，接触性过敏反应滴度（TCH）从原液到1:100不等。我们得出结论，银胶菊皮炎偶尔可能在形态和分布上出现与光敏性苔藓样疹的皮损非常相似的损害。需要认识到银胶菊皮炎的这种临床表现以避免误诊。
