Erythema multiforme like reaction to santos rosewood (Machaerium scleroxylon) andTorreya nucifera

Abstract

Erythema multiforme is a skin disorder characterised by target epithelial eruption, which is mainly caused by infection or drugs. In this case, we report an erythema multiforme like reaction caused by contact dermatitis against wood, especially santos rosewood. During the hospitalisation, we performed a patch test with lumber used in the patient’s workplace, and recognised a positive response to multiple woods and a simultaneous recurring eruption (flare up) outside of the test site. The findings from this case of contact dermatitis caused by frequently used industrial wood type is important for the management of occupational environments. A review of the literature on erythema multiforme like reaction due to contact dermatitis, including past case reports, has also been provided.

Presentations to emergency departments in Melbourne, Australia diagnosed as allergic contact dermatitis

“…Pain was found to be a symptom in 19.3% and swelling was seen in 21.5%. Pain, particularly reported with burning sensations, has previously been reported in severe cases of ACD requiring hospitalization 5,18 . The most common distribution of rashes in our study was the face followed by the arms.…”

“…Other reported cases of ACD presenting to ED have included erythema multiforme‐like reactions caused by contact dermatitis to wood, namely rosewood 18 . Other trees such as the “tree of heaven” ( Ailanthus altissima ) have also caused severe ACD requiring ED treatment 19 …”

“…Other reported cases of ACD presenting to ED have included erythema multiforme-like reactions caused by contact dermatitis to wood, namely rosewood. 18 Other trees such as the "tree of heaven" (Ailanthus altissima) have also caused severe ACD requiring ED treatment. 19 Lai-Kwon et al found that 4% of presentations to ED in a single tertiary centre in Melbourne between 2009 and 2011 were the result of a skin condition.…”

Cutaneous reactions after contact with santos palisander (Machaerium scleroxylon)

“…So far, individual cases of bullous erythema multiforme caused by contact with santos palisander have been described in literature [10,11,13,14]. Given the above, this exotic wood should be noted as a potent contact allergen that may cause not only contact dermatitis, but also severe bullous erythema multiforme.…”

“…Dotychczas opisano w piśmiennictwie pojedyncze przypadki rumienia wielopostaciowego pęcherzowego spowodowanego kontaktem z palisandrem boliwijskim [10,11,13,14]. W związku z tym to egzotyczne drewno powinno być odnotowane jako silny alergen kontaktowy, który może wywoływać nie tylko kontaktowe zapalenie skóry, lecz także ciężki rumień wielopostaciowy typu pęcherzowego.…”