Introduction
The accidentally’ imported parthenium has become health hazard to
man and animals leading to socio-psycho - economic problems. Parthenium is known to cause
various skin problems. The diagnosis can be confirmed by doing the patch test.
Case Studies
Case I
A 58 year old farmer reported with itchy lesions over the face, neck and dorsal aspect
of the hands, since 8-10 years. The itching and lesions .used to increase in summer and
late winter. On examination, he had hyper pigmented papules over the forehead, cheeks and
ears. The lesions were also seen over the nape of the neck and dorsal aspect of the hands.
Mild scaling was present. After treating the patient with oral and topical steroids, he
was relieved of symptoms. Patch test was done to confirm the diagnosis
Case II
A 45 year old farmer reported to the clinic with oozing wound over the hand with
burning sensation. The lesion was seen after removing the parthenium weed from his farm.
Similar lesions were seen in earlier years also following the handling of the weed. The
wound was cleaned and treated with antibiotics and steroids. The patient was advised not
to handle the parthenium weed.
Case III
A 52 year old agriculturist came with painful lesion over the right side of the neck
since five days. He had the history of carrying parthenium on his shoulder present. On
examination, excoriation, crusting and oozing was noticed over the right lateral aspect of
the neck. Diagnosis of contact irritant dermatitis secondary to parthenium was made and
confirmed by patch test. The patient was treated with antibiotics and steroids. The lesion
healed completely.
Case IV
A 40 year old lady field worker came to the clinic with the complaints of painful oozing
lesions over the right forearm. The patient also complained of fever with chills. On
examination, there were multiple pustules, vesicles, erosions and oozing over the right
forearm. Diagnosis of contact irritant dermatitis was made and later confirmed by patch
test. On treatment she improved considerably.
Case V
A 48 year old village accountant presented himself in the clinic with the history of
itching over the face and cubital fossae since several years. On examination, hyper
pigmented papules were noted over the forehead, around the nostrils, behind the ears, 'V
of the neck and flexor aspect of forearms. Diagnosis of air borne contact dermatitis was
made. Patch test to various pollens and plants revealed that, the patient was sensitive to
parthenium.
Case VI
A 10 month old male child was brought to the clinic with the history of itchy lesions over
the body. The parents had applied parthenium paste over a wound at right leg. Following
the application, the child developed multiple lesions all over the body. On examination,
multiple oozing lesions with crusting were present all over the body. Diagnosis of contact
irritant dermatitis secondary to parthenium with Id reaction was made. Patient became
alright after treating him with antibiotics and steroids.
Case VII
A 65 year old tractor driver complained of itching over the face, neck, arms and legs
with swelling of face since 7-8 days. Repeated history of itching was reported since many
years. On examination, oedema of face was present. Scaly papules were present over the
face and neck. Diabetes and other systemic diseases were ruled out. Diagnosis of photo
phytodermatitis was made. After the patch test, parthenium was found to be the main cause.
The patient improved with the treatment. He attended the out patient department repeatedly
due to its relapse. Inspite of asking him to change the job, he did not do so. Ultimately
he committed suicide for not withstanding the mental torture and financial burden.
Discussion
Parthenin an incomplete antigen of parthenium when enters the dermis,
combines with albumin in presence of ultraviolet rays and becomes complete antigen. There
will be antigen and antibody reaction thus causing photo phyto dermatitis (Fisher, 1952
and Sjorrs, 1976). Such reactions will be seen over portions of the body exposed to the
sun i.e. over the forehead, molar area, nose and chin, 'V of the neck, dorsum of the hands
and
feet. The parthenin when comes in contact with the skin can cause
hypersensitivity reaction leading to oozing, crusting associated with pain and burning
sensation which is called as contact irritant dermatitis (Siddiqui et al., 1978).
Parthenium is responsible for the large number of air borne contact dermatitis in India.
Here the lesions are seen over the forehead, below the eyebrows, around the nostrils,
behind the ears and neck. It can be seen over the cubital fossae and popliteal fossae
also. This is a type of allergic reaction (Tiwari et al., 1979). In Denmark and Australia
it is called as Bush Dermatitis (Burry, 1973).
Patch testing is a process wherein the extract of the plant is placed
over the skin and covered. After 48 h. the patch is removed and seen for any changes over
the skin. This is a type of epicutaneous test. Such tests help in confirmation of the
diagnosis (Pascricha and Singh, 1982).
Whoever develops the photo phyto dermatitis, he has to avoid the direct
exposure to sunlight and parthenium. He has to change his occupation and try to work in
the shady areas or at night. A person who develops air borne contact dermatitis due to
parthenium has to work indoor only and has to change his occupation. If the person
develops contact dermatitis, he has to avoid the handling of parthenium weed. Of late, the
incidence of all the above three conditions is falling down considerably due to decrease
in the population of parthenium. After going through the cases presented, everybody will
agree that parthenium is harmful even to the extent of making a person to commit suicide.
References
Bajaj, A.K., D. C. Govil and S. N. Bhargava. 1982. Contact
dermatitis due to plants. Indian. J. Dermatol. Venereal Leprol. 48:268-270,
Burry, D. N. 1973. Med. J. Aust. 1: 110.
Fisher, A. A. 1952. J. Invest. Dermatol. 19: 271.
Pascricha, J. S. and S. N. Singh. 1982. Evaluation of the antigen -
impregnated - discs for patch tests. Indian. J. Dermatol. Venereal Leprol. 48: 327-329.
Siddiqui, M. A., R. Singh and R. C. Sharma. 1978. Contact dermatitis
due to Parthenium hysterophourus. Indian. J. Med. Res. 68: 481-484.
Sjorrs, F.T. 1976. Cutis 18: 681.
Tiwari, V. D., A. S. Sohi and T. R. Chopra. 1979. Allergic contact
dermatitis due to Parthenium hysterophorus. Indian. J. Dermatol. Venereal Leprol. 45 :
392-400.
(Source : Kololgi et. al. (1997). In : Proc. First International
Conference on Parthenium Management (Vil. I). : 18-19) |