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Allergic contact dermatitis from Mentha spicata (spearmint)

Case Report A 64-year-old non-atopic woman, with a history of contact dermatitis from shoes and leather items, presented with painful erythemato-edemato-vesico-bullous lesions on the right knee after repeated applications of compresses with an infusion made with fresh leaves of Mentha spicata, for pain in the knee due to gonarthrosis. The clinical signs and symptoms regressed after suspension of the compresses and treatment with topical antiseptics and oral antihistamines. Patch tests with the SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) standard series yielded positive reactions to potassium dichromate, para-phenylenediamine, Disperse Blue 124, Disperse Yellow 3, fragrance mix, and Myroxylon Pereirae resin. A patch test with an alcoholic extract of the leaves of Mentha spicata elicited an erythemato-vesicular reaction. Patch tests with a further series (Table 1) were positive to peppermint and spearmint oils, whereas menthol was negative. Photopatch tests were negative.