Abstract
This case report indicates a complication of a footbath with herbs, self-applied by a patient at home. A 60 year old female patient presented herself at the TCM (Traditional Chinese Medicine) hospital, Bad Kötzting, Germany with the main symptoms of persistent coughing fits and disturbing smells especially during meals. At admission, she was administered a high dose Chinese herbal therapy complementary to her already prescribed pharmaceuticals. During her sojourn in the hospital she started suffering from numbness in both feet, preferred on the dorsum, and up to and including the toes, accompanied with a sensation of cold. Therefore TCM herbal footbaths containing 5g Psoraleae fructus semen (Buguzhi) were administered, twice a day, for 2 weeks, during the hospital stay without any complications. One week after discharge from the hospital she went on with her footbaths, prescribed for outpatient treatment. Buguzhi is suspected to cause phototoxic reactions under sunlight. Unfortunately, the patient applied the prescription-based footbath under a parasol in her garden. This seems to be the reason, why the patient developed an erythema bullosa grade three. She was treated with antibiotics for 10 days and ointment bandages until remission. To avoid similar adverse events in future, patients have to be informed to not expose their skin to solar irradiation during or after footbaths containing Buguzhi. Alternatively it has to be considered to omit Buguzhi for the use of footbaths applied as outpatient treatment.
Highlights
It has to be considered to omit Buguzhi for the use of footbaths applied as outpatient treatment
Psoralen, extracted from the plant Psoraleae corylifolia, plus ultraviolet A (PUVA) photochemotherapy combines the use of psoralen as a bath and long-wave ultraviolet A (UVA) radiation
We report a case of a female patient who was prescribed a psoralen containing herbal footbath for outpatient treatment
Summary
It has to be considered to omit Buguzhi for the use of footbaths applied as outpatient treatment. When applied externally skin-allergic reactions have been reported when Psoralea treated skin areas were exposed to sun light [4]. This adverse effect is harnessed in the treatment of psoriasis. Psoralen, extracted from the plant Psoraleae corylifolia, plus ultraviolet A (PUVA) photochemotherapy combines the use of psoralen as a bath and long-wave ultraviolet A (UVA) radiation. In this context skin phototoxicity is reported and the occurrence of a phototoxic erythema as most common adverse event [5,6]. Without being aware of the phytotoxic effect or Buguzhi she exposed her feet to solar irradiation during and after the footbath and thereby provoked the formation of a phytotoxic erythema
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