Dermatitis from common ivy (Hedera helix L. subsp. helix) in Europe: past, present, and future

Abstract

Common ivy (Hedera helix subsp. helix) is a well-known native and ornamental plant in Europe. Reports on contact dermatitis from ivy have regularly appeared since 1899. Recently, it has been suggested that allergic contact dermatitis from the plant may be under-diagnosed, partly due to lack of commercial patch test allergens. The objective of the article is to present the results of aimed patch testing with the main common ivy allergen, falcarinol, during a 16-year period and review the newer literature. Consecutive patients tested with falcarinol 0.03% petrolatum from May 1993 to May 2009 were included. Cases published since 1987 were retrieved from the PubMed database. One hundred and twenty-seven Danish patients were tested with falcarinol and 10 (7.9%) tested positive. Seven were occupationally sensitized. Between 1994 and 2009, 28 new cases of contact dermatitis from ivy were reported, 2 of which were occupational. Only 11 of the 28 patients were tested with pure allergens. Falcarinol is not only widely distributed in the ivy family, but also in the closely related Apiaceae. Sensitization may occur in childhood or in adults pruning ivy plants or handling them in an occupational setting. In view of the ubiquity of falcarinol-containing plants and the relatively high prevalence of positive reactions in aimed patch testing, falcarinol should be the next plant allergen to be commercially available and included in the plant series worldwide.

An unusual clinical presentation of allergic contact dermatitis to common ivy

“…Allergic contact dermatitis to common ivy ( Hedera helix L. Spp helix) is well known, even though irritant contact dermatitis is more frequent . In our two cases, the pattern of the patch tests was suggestive of a mixture of allergy and irritancy.…”

“…Such an atypical clinical pattern has been previously reported with some plants, including primrose, exotic woods, poison ivy, and more recently, Geranium robertianum , but not with common ivy, to the best of our knowledge . As suggested by some authors, it would be relevant to include falcarinol in the plant series testing owing to the relatively high frequency of common ivy‐related allergic contact dermatitis in Europe …”

Contact dermatitis as an adverse reaction to some topically used European herbal medicinal products – Part 2: Echinacea purpurea–Lavandula angustifolia

“…The allergenicity of falcarinol has also been shown in human volunteers . A number of patch test studies in patients being investigated for sensitivity to H. helix have now shown reactivity to falcarinol and to didehydrofalcarinol.…”

“…It may be deduced from the literature that sensitization to H. helix is predominantly a hazard for gardeners, horticulturists, and those involved in similar such occupations who come into contact with damaged plant material . However, falcarinol has been detected in a H. helix extract‐containing cosmetic product, so it is possible that individuals who have become sensitized through contact with damaged H. helix (knowingly or unknowingly) could react to such products .…”

Recent Advances in Research on Lacquer Allergy

“…[45][46][47][48] Because the allergens of poison ivy! oak have the same structure as urushiol, the treatment methods and medicines also can be used to treat dermatitis caused by urushiol.…”