Reactions 1337 - 5 Feb 2011

Herbal oil

Leukoderma: 2 case reportsTwo patients developed leukoderma following

application of topical herbal oils.A 42-year-old man presented with a 3-week history of

localised alopecia and whitening of his scalp. Hissymptoms were preceded by topical application of a herbaloil [dosage not stated; duration of treatment to reactiononset not clearly stated] for scalp psoriasis* . Physicalexamination revealed 2 depigmented patches withleukotrichia and nonscarring alopecia with lesions on otherparts of his scalp that were suggestive of scalp psoriasis. Hewas advised to discontinue the herbal oil, applybetamethasone dipropionate and use a shampoocontaining tar and salicylic acid. His alopecia,hypopigmentation and scalp psoriasis improvedsignificantly over the next 1.5 months.

A 35-year-old woman presented with a 2-week history ofasymptomatic, localised white patches on her breast. Shehad been applying herbal oil** topically to her nipples andperiareolar areas for 4 weeks, to treat mild discomfort[dosage not stated]. Physical examination revealed twobilaterally symmetric depigmented maculae on her areolae.The oil was discontinued and she was advised to applytacrolimus to the maculas. Complete repigmentation wasachieved in 2 months and tacrolimus was stopped. Therewas no recurrence of lesions over a 6-month follow-upperiod. Herbal oil-induced chemical leukoderma wasdiagnosed in both cases.

Author comment: "We could not precisely determine anyspecific ingredient of the oils as the cause of [chemicalleukoderma].

* The herbal oil contained: Rubia cordifolia, Eclipta alba,Pterocarpus santalinus, Sida cordifolia, Berberis aristata, Mesuaferrea, Glycyrrhiza glabra, Saussuria lapa, Hemidesmus indicus,Terminalia belerica, Phyllanthus emblica, Lawsonia inermis,Nardostachys jatamansi, Bacopa monnieri, Indigofera tinctoria,Convolvulus pluricalis and Sesamum indicum.** The herbal oil contained: Curcuma longa, Callicarpamacrophylla, Mimosa pudica, Hedychium spicatum, Withaniasomnifera, Gmelina arborea, and Sesamum indicum.

Ghosh SK, et al. Chemical leukoderma induced by herbal oils. Journal ofCutaneous Medicine and Surgery 14: 310-313, No. 6, Nov-Dec 2010. Availablefrom: URL: http://dx.doi.org/10.2310/7750.2010.09075 - India 803048987

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Reactions 5 Feb 2011 No. 13370114-9954/10/1337-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved