{'fraction_non_alphanumeric': 0.029511918274687854, 'fraction_numerical': 0.00340522133938706, 'mean_word_length': 5.41747572815534, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Biologic‐induced urticaria due to polysorbate 20

line series including sesquiterpene lactone mix. We found positive reactions (++, according to the International Contact Dermatitis Research Group criteria) to sesquiterpene lactone mix (Fig. 1c), which led us to suspect allergic contact dermatitis from contact with his plants. We conducted further patch tests with several plants from his own garden, and they showed a +++ reaction to Chrysanthemum (Fig. 1d). We also obtained a + reaction to garland Chrysanthemum and lettuce, both of which belong to the Asteraceae family. We applied a photopatch for Chrysanthemum to the skin for 48 h, and irradiated with UV-A at 2 J/cm. Twenty-four hours later, Chrysanthemum was slightly enhanced, indicating a positive reaction (Fig. 1d). We diagnosed chronic actinic dermatitis (CAD) accompanied by UV-A photosensitivity due to Chrysanthemum and suggested that he should avoid Asteraceae and direct sun exposure. He has been able to avoid Chrysanthemum exposure continuously (but not exposure to the sun). Treatment with topical corticosteroids and tacrolimus relieved his symptoms. Nine months after the first diagnosis, we repeated the phototest, which no longer showed a positive reaction to UV-A. Clinical findings also improved significantly (Fig. 1e,f). Chronic actinic dermatitis caused by UV-A, UV-B and occasionally, visible light, sometimes affects the face, neck and hands. Chrysanthemum in the family Asteraceae is related to CAD, and one of the allergens responsible is considered to be sesquiterpene lactone. Contact dermatitis usually appears on gardeners or funeral parlor employees who often handle Asteraceae. Photosensitivity often accompanies this disease. Although it is not known clearly whether photosensitivity just coincidentally accompanies Chrysanthemum contact dermatitis, Fuchs et al. proposed that products of sesquiterpene lactone induced by UV-B could be the cause of CAD development. Our case showed an allergy to sesquiterpene lactone and may support this proposal because avoiding contact exposure to Chrysanthemum can lead to the complete remission of photosensitivity. Some reports state that Chrysanthemum contains several specific allergens for contact dermatitis, including helenin and arteglasin-A. We suspect that those Chrysanthemum-specific allergens could turn into chromophores under UV-A stimulation. In the case reported here, after avoiding exposure to chrysanthemums, and once the Chrysanthemum-specific allergens disappeared from the surface of his skin, the generation of chromophores might have stopped and the dermatitis was resolved accordingly.