Occupational Dermatitis Due to Lettuce

Abstract

the cataract norm based on thousands of cases tabulated by fifty or a hundred men in different parts of the country, one might tell the truth and prevent the fears by showing the record. One recent writer has justified his continued treatment by saying: "It is salutary and reassuring to the average patient to offer hope of arresting a condition which he regards as hopeless." This is probably the attitude of many who persistently treat these patients and, if the case does not progress, allow them to believe that the treatment has retarded it. We have voted to refer to a committee the expediency of appointing a committee on norms. I suggest that in recognition of the wisdom of our Nestor in ophthalmology, it be called the Jackson Committee on Norms.

Lettuce contact allergy

“…The widespread dermatitis in Krook's gardener probably reflects the working conditions, with close manual contact with lettuce in a confined space, which may have been polluted with lettuce sap. On the other hand, persons who handle lettuce in shops or kitchens seem to have primarily dermatitis of the hands and forearms, and rarely facial involvement . This is also reflected in the present study, even though the clinical aspects were described in 5 persons only; they all worked in kitchens, and their main complaint was hand eczema (Table ).…”

“…Concerning testing with leaves, the results were not consistent: 2 patients reacted positively to leaf wetted with water and 1 to leaf wetted with ethanol (Table ). Strongly positive patch test reactions to lettuce leaves have been reported, but the reactions probably reflect the fact that the patients were highly sensitive after occupational exposure (,,,,,,). Furthermore, Krook reported on a lettuce gardener who only had skin problems after exposure to full‐grown plants; this is in accordance with the fact that the concentration of SLs increases on bolting (,).…”

“…Epidemiological studies on the prevalence of lettuce sensitization are not available. Obviously, the majority of the older literature consists of mostly occupational case reports or small case series . An exception is the study of Veien et al.…”

“…Any person engaged in cultivation, harvesting, packing, retail trading or food preparation involving lettuce is potentially at risk. Thus, the literature reports sensitization in gardeners and greenhouse workers , a lettuce packer , a greengrocer , a produce manager , a shop assistant in the vegetable department of a supermarket , a food services advisor, a kitchen assistant, chefs , cold‐buffet managers , salad makers , a restaurant keeper , and food handlers in general . Furthermore, lettuce sensitization has been reported in non‐occupationally exposed persons .…”

“…According to Hausen, lettuce contact allergy may be diagnosed by patch testing with lactucin and/or lactucopicrin 1% pet., a short ether extract of lettuce 10% pet., or the plant or the sap as is (1). The first case of lettuce contact allergy was reported by Rinkel and Balyeat in 1932 in a female salad maker with occupational dermatitis (13). When the patient did not react to a scratch test with lettuce, which was the only method employed by the authors until then, they invented a lettuce contact test by bandaging lettuce on her upper arm (13).…”