Primrose dermatitis L23.7

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Primrose disease

Definition
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Acute allergic contact eczema due to primrose contact mainly on the face, hands, but also on the whole integument and even on the oral mucosa is possible.

Occurrence/Epidemiology
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Preferably women are affected. Occupationally caused primrose allergy among florists and gardeners is still reported in individual cases.

The sensitization rates were in different countries. Collectives with routine testing of Primin between 0,3 - 1,0% . In a Danish study from 1984 to 1989 the sensitisation rate was 1.8% (57 out of 3075).

In a larger (Italian) collective of patients with potential contact sensitization (n=24,000), Bongiorni L et al. (2015) were able to demonstrate a Primin sensitization rate of 1.9%, with women (2.6%) being sensitized more often than men (0.5%). In certain areas of Italy (Pordonne) even higher sebisbilisation rates (up to 6%) were detected.

Cross-reactions with structurally similar quinones found in other plants or wood species, e.g. Dalbergia species, teak (Tectona grandis) or Pao ferro (Macherium skleroxylon) are possible, but are rarely observed.

Etiopathogenesis
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Primin is one of the strongest known allergens. It was therefore often used as a model substance for studying allergic reactions in humans. Sensitization is achieved by contact with the glandular hair secretion of Primula obonica (poison primrose, cup primrose). The allergenic effect depends on the content of primine.

Remark: The medically used primula species contain almost no primin (see below primrose = primula veris).

Therapy
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Avoidance of the allergen (remove primroses from the home), stage-appropriate treatment of eczema, corresponding to the allergic contact eczema.

Note(s)
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The epicutaneous test is recommended with synthetic primin in vaseline at a concentration of 0.01%.

Literature
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  1. Bongiorni L et al (2015) Primin sensitization in north-eastern Italy: a temporal trend from 1996 to 2012. contact dermatitis 73:108-112.
  2. Hervella-Garcés M et al (2016) en representación del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC).the Spanish standard patch test series: 2016 update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). Actas Dermosifiliogr 107:559-566.
  3. Zachariae C et al (2007) Primin in the European standard patch test series for 20 years. Contact dermatitis 56:344-346

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020