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What happens to patients with soluble‐oil dermatitis?

Compositae plants can cause a distinct pattern of allergic contact dermatitis, but other patterns easily go unrecognized. The airborne distribution, which mimics photosensitivity, is well known; other patterns are not so familiar. In July 1987 a mix of three sesquiterpene lactones (Compositae allergens) was added to our standard patch-test series and, of 2273 patients tested, 60 (2-6%) reacted. This group of 60 Compositae-sensitive patients comprised 32 males and 28 females with a median age of 60 (range 18-81 years). The hands were the primary site of the eczema in 38 patients, the face in eight, and the eczema was widespread in 14. A diagnosis of photodermatitis was suspected in 21 patients and confirmed in 14 by abnormal monochromator light tests. Prior to patch testing the diagnosis of Compositae dermatitis was made in only 10 of the 60 patients. Patients with Compositae dermatitis may present with hand and/or face dermatitis, or photosensitivity, or with a more widespread dermatitis. The incidence of sensitization, 26%, is high and unexpected. To avoid missing cases of sensitization, this allergen should be included in the standard series.