herbal oil

Reactions 1337 - 5 Feb 2011 Herbal oil Leukoderma: 2 case reports Two patients developed leukoderma following application of topical herbal oils. A 42-year-old man presented with a 3-week history of localised alopecia and whitening of his scalp. His symptoms were preceded by topical application of a herbal oil [dosage not stated; duration of treatment to reaction onset not clearly stated] for scalp psoriasis * . Physical examination revealed 2 depigmented patches with leukotrichia and nonscarring alopecia with lesions on other parts of his scalp that were suggestive of scalp psoriasis. He was advised to discontinue the herbal oil, apply betamethasone dipropionate and use a shampoo containing tar and salicylic acid. His alopecia, hypopigmentation and scalp psoriasis improved significantly over the next 1.5 months. A 35-year-old woman presented with a 2-week history of asymptomatic, localised white patches on her breast. She had been applying herbal oil ** topically to her nipples and periareolar areas for 4 weeks, to treat mild discomfort [dosage not stated]. Physical examination revealed two bilaterally symmetric depigmented maculae on her areolae. The oil was discontinued and she was advised to apply tacrolimus to the maculas. Complete repigmentation was achieved in 2 months and tacrolimus was stopped. There was no recurrence of lesions over a 6-month follow-up period. Herbal oil-induced chemical leukoderma was diagnosed in both cases. Author comment: "We could not precisely determine any specific ingredient of the oils as the cause of [chemical leukoderma]. * The herbal oil contained: Rubia cordifolia, Eclipta alba, Pterocarpus santalinus, Sida cordifolia, Berberis aristata, Mesua ferrea, Glycyrrhiza glabra, Saussuria lapa, Hemidesmus indicus, Terminalia belerica, Phyllanthus emblica, Lawsonia inermis, Nardostachys jatamansi, Bacopa monnieri, Indigofera tinctoria, Convolvulus pluricalis and Sesamum indicum. ** The herbal oil contained: Curcuma longa, Callicarpa macrophylla, Mimosa pudica, Hedychium spicatum, Withania somnifera, Gmelina arborea, and Sesamum indicum. Ghosh SK, et al. Chemical leukoderma induced by herbal oils. Journal of Cutaneous Medicine and Surgery 14: 310-313, No. 6, Nov-Dec 2010. Available from: URL: http://dx.doi.org/10.2310/7750.2010.09075 - India 803048987 1 Reactions 5 Feb 2011 No. 1337 0114-9954/10/1337-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

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Reactions 1337 - 5 Feb 2011

Herbal oil

Leukoderma: 2 case reportsTwo patients developed leukoderma following

application of topical herbal oils.A 42-year-old man presented with a 3-week history of

localised alopecia and whitening of his scalp. Hissymptoms were preceded by topical application of a herbaloil [dosage not stated; duration of treatment to reactiononset not clearly stated] for scalp psoriasis* . Physicalexamination revealed 2 depigmented patches withleukotrichia and nonscarring alopecia with lesions on otherparts of his scalp that were suggestive of scalp psoriasis. Hewas advised to discontinue the herbal oil, applybetamethasone dipropionate and use a shampoocontaining tar and salicylic acid. His alopecia,hypopigmentation and scalp psoriasis improvedsignificantly over the next 1.5 months.

A 35-year-old woman presented with a 2-week history ofasymptomatic, localised white patches on her breast. Shehad been applying herbal oil** topically to her nipples andperiareolar areas for 4 weeks, to treat mild discomfort[dosage not stated]. Physical examination revealed twobilaterally symmetric depigmented maculae on her areolae.The oil was discontinued and she was advised to applytacrolimus to the maculas. Complete repigmentation wasachieved in 2 months and tacrolimus was stopped. Therewas no recurrence of lesions over a 6-month follow-upperiod. Herbal oil-induced chemical leukoderma wasdiagnosed in both cases.

Author comment: "We could not precisely determine anyspecific ingredient of the oils as the cause of [chemicalleukoderma].

* The herbal oil contained: Rubia cordifolia, Eclipta alba,Pterocarpus santalinus, Sida cordifolia, Berberis aristata, Mesuaferrea, Glycyrrhiza glabra, Saussuria lapa, Hemidesmus indicus,Terminalia belerica, Phyllanthus emblica, Lawsonia inermis,Nardostachys jatamansi, Bacopa monnieri, Indigofera tinctoria,Convolvulus pluricalis and Sesamum indicum.** The herbal oil contained: Curcuma longa, Callicarpamacrophylla, Mimosa pudica, Hedychium spicatum, Withaniasomnifera, Gmelina arborea, and Sesamum indicum.

Ghosh SK, et al. Chemical leukoderma induced by herbal oils. Journal ofCutaneous Medicine and Surgery 14: 310-313, No. 6, Nov-Dec 2010. Availablefrom: URL: http://dx.doi.org/10.2310/7750.2010.09075 - India 803048987

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