Pyrethrum allergic contact dermatitis in humans--real?, common?, or not documented? An evidence-based approach.

Pyrethrum has been reported to produce allergic contact dermatitis in humans. Moreover, it has been speculated that cross reactions occur in ragweed-sensitized people. This review presents the botany, contemporary chemistry, and case reports of alleged allergic contact dermatitis. Our interpretation suggests that the evidence presented in literature does not show that allergic contact dermatitis results from exposure to pyrethrum. Similarly, the data do not suggest cross reactions in ragweed-sensitized people. Changes in the chemical composition of the refined pyrethrins suggest the putative sensitizer is present at a lower level in today's refined extracts than in ground pyrethrum flowers or the extracts used earlier.