contact dermatitis due to centella asiatica
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CONTACT DERMATITIS 2010: 62: 54–65 • JOHN WILEY & SONS A/S 2010 • ALL RIGHTS RESERVED
• CONTRIBUTIONS TO THIS SECTION WILL NOT UNDERGO PEER REVIEW, BUT WILL BE REVIEWED BY THE EDITOR •
Contact dermatitis dueto Centella asiatica
Contact Dermatitis 2010: 62: 54–55
Joana Gomes, Teresa Pereira, CatarinaVilarinho, Maria da Luz Duarte and CelesteBrito
Department of Dermatology andVenereology, Sao Marcos Hospital,Braga, Portugal
Key words: allergic contact dermatitis; Cen-tella asiatica; Indian pennywort; Madecassol.
Centella asiatica is an herbaceousplant of the Umbelliferae family,widely used on surgical wounds,keloids, hypertrophic scars, leg ulcers,
Fig. 1. Positive reaction to Centella asiatica extract (1% and 5% pet.).
phlebitis, cellulitis, and striae dis-tensae (1). It is claimed to haveactions on various phases of woundrepair, stimulating extracellular matrixaccumulation and collagen syn-thesis. Centella contains severalactive constituents, of which themost important are the triterpenoidsaponins–asiaticoside, madecassoside,and asiatic acid (1).
Case ReportA 42-year-old non-atopic woman withno relevant past history presentedwith localized, severe eczema on herneck and upper chest, after treating ahypertrophic thyroidectomy scar withMadecassol® ointment. She requiredsystemic corticosteroid therapy. One
month later, patch tests were per-formed with the ointment (tested ‘asis’) and its ingredients, provided bythe manufacturer and prepared accord-ing to the concentrations found inthe literature. We obtained positivereactions to the ointment itself as wellas to C. asiatica extract (1% and 5%pet.) and weak reactions (probably ofirritant nature) to lavender oil (20%pet.) and propylene glycol (5% pet.)(Fig. 1). Patch tests with C. asiaticaextract 1% and 5% in 20 controls werenegative.
DiscussionThere are few well-documented reportsof contact allergy to C. asiatic demon-strated by patch testing (2–6). The
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low sensitizing capacity of the threetriterpenic compounds might beexplained by their relatively highmolecular weight (487–503) (1).Even though applied frequentlyto the damaged skin, the risk ofcontact dermatitis is consideredlow (1, 2).
References1. Hausen B M. Centella asiatica (Indian
pennywort), an effective therapeutic buta weak sensitizer. Contact Dermatitis1993: 29: 175–179.
2. Eun H C, Lee A Y. Contact dermatitisdue to madecassol. Contact Dermatitis1985: 13: 310–313.
3. Izu R, Aguirre A, Gil N, Dıaz-PerezJL. Allergic contact dermatitis froma cream containing Centella asiaticaextract. Contact Dermatitis 1992: 26:192–193.
4. Danese P, Carnevali C, Bertazzoni M G.Allergic contact dermatitis due to Cen-tella asiatica extract. Contact Dermatitis1994: 31: 201.
5. Bilbao I, Aguirre A, Zabala R,Gonzalez R, Raton J, Diaz Perez JL.Allergic contact dermatitis from butox-yethyl nicotinic acid and Centella asi-atica extract. Contact Dermatitis 1995:33: 435–436.
6. Gonzalo Garijo M A, Revenga Arranz F,Bobadilla Gonzalez P. Allergic contactdermatitis due to Centella asiatica:a new case. Allergol Immunopathol(Madr) 1996: 24: 132–134.
Address:Joana GomesDepartment of Dermatologyand VenereologySao Marcos HospitalBragaPortugalTel: 00351 253209022Fax: 00351 253613334e-mail: [email protected]