Tropical-Wood-Induced Bullous Erythema multiforme

Abstract

We report a case of bullous erythema multiforme caused by an exotic wood, pao ferro (Machaerium scleroxylon). A 25-year-old female, a luthier (guitar maker) who often handles a variety of woods, developed bullous erythema multiforme. A patch test confirmed a positive reaction to one of the exotic woods, pao ferro. A subsequent accidental short contact with pao ferro 5 months following the first incidence induced a similar exudative erythema. Exotic woods such as pao ferro should be added to the list of contact allergens that can induce bullous erythema multiforme.

Occupational fixed drug eruption with ipe wood

“…Ipe is a tropical tree that is well known for its brown colour and its high concentration of naphthoquinones, namely lapachol, deoxylapachol, lawsone, and lapachenol . Previous cases of fixed eruption related to plants have been reviewed by Raison‐Peyron, and several cases of multiforme‐like eruptions have been reported with other exotic woods . Both contact dermatitis and occupational asthma have been described with ipe sawdust, but, to our knowledge, this is the first fixed eruption to be documented in a woodworker.…”

Erythema multiforme due to contact with weeds: a recurrence after patch testing

“…It has been noted that EM may occur without an eczematous component (2), concurrently with acute allergic contact dermatitis (13), or during resolution of acute allergic contact dermatitis (abrupt withdrawal of systemic corticosteroid treatment) (15). EM represented the only lesions our patient ever had.…”

“…Contact EM (CEM) is a rare noneczematous manifestation of allergic contact dermatitis, which can be elicited by multiple allergens in a given patient, and has been attributed to diverse common and potent allergens. EM due to contact with exotic woods (2) and various plants, such as Compositae ( Artemisia vulgaris, Inula helenium ), Primulaceae ( Primula ), Anacardiaceae ( Toxicondendron radicans ), Hypericaceae ( Hypericum erectum ), and Salanaceae ( Capsicum ), is well recognized (3). What is extremely rarely seen is an EM reaction as a complication of patch testing (PT).…”

Hämatogenes Kontaktekzem mit EEM-Charakter nach beruflichem Umgang mit Pao ferro-Holz (Machaerium scleroxylon Tul.)

“…Wie in diesem und in früheren Fällen beobachtet, treten Streuphänomene mit EEM-ähnlichem Charakter auf [2,3,14,21,22]. Unter allen Nutzhölzern aus tropischen Gebieten kommt dem Pao ferro-Holz, trotz der geringen Importmengen, auch heute noch ein nicht zu unterschätzendes allergologisches Risiko zu.…”