Dermite de contact secondaire à l’application du laurier rose (Nerium oleander)

Abstract

IntroductionNerium Oleander is a plant that usually grows in the Mediterranean area, which known by its systemic toxicity. Its cutaneous effects are not well known, with few publications in the literature. Here we report a case of a patient who presents an acute eczema following the local application of the Nerium oleander leaves. ObservationOur case was of a 21 years old male, He had no medical history especially atopy, or a previous use of plants. He have applied directly by friction the root of the Nerium Oleander on the cheeks and the chin, without any oral ingestion. Six hours later, he noticed a sudden onset of an ill-defined erythematous and edematous closet with intense itching, surmounted with Vesicles, bullae and oozing in the area of application of the plant, with a satisfactory evolution following the prescription of topical corticosteroid for 10 days and a barrier cream. DiscussionNerium Oleander is an ornamental plant that is very common in Morocco and it grows in wetlands. The active ingredients are cardiac glycosides. Oleandrine is the main toxic heteroside. Its topical use is commun in alternative medicine, for various disorders, especially Scabies, hemorrhoid, boils and hair loss. In our case, this plant was used for acne lesions. Anamnesis did not reveal the notion of exposure to another allergen. The toxicity of the Nerium Oleander is close to the effect of digitalis, among these effects we mentioned: cardiac effects, including conduction disorders, arrhythmias with a significant risk of circulatory collapse and sudden death, neurological effects with a risk of convulsions, digestive such as the irritation of oral mucosa, hyper salivation, nausea and vomiting or gastroenteritis. As well as malaise and shivering. ConclusionIn addition of the systemic effects of the Nerium Oleander, this observation reminds it methods of use, just as much as the non-negligible probability of occurrence of cutaneous reactions.