Allergic contact dermatitis caused by Helichrysum italicum contained in an emollient cream.

A 69-year-old non-atopic woman presented with eczematous lesions on her legs, trunk, and upper limbs. The history revealed that, one month before the development of the eczema, she had been applying an emollient cream to her legs (BioEulen Pediatric Cream, Aboca, Sansepolcro, Italy) based on natural ingredients to treat a moderate xerosis. She was treated with topical corticosteroids (mometasone furoate) with a once-daily application for 2 weeks, and instructed to avoid further contact with the suspected topical product. Three months after the complete resolution of the lesions, she was patch tested with the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) standard baseline series (Euromedical®, Calolziocorte, LC, Italy), with our ‘natural ingredients’ series (Firma®, Florence, Italy) (Table 1), and with the emollient cream ‘as is’. Patch tests were applied on the back, and left in place for 2 days with Finn Chambers® (diameter 8 mm; SmartPractice®, Phoenix, AZ, USA) on Scanpor® tape (Norgesplaster A/S, Vennesla, Norway). Readings were performed at D2 and D4. The reactions were classified according to the International Contact Dermatitis Research Group guidelines. Readings showed positive reactions (++) to Myroxylon pereirae and to the cream ‘as is’. Hence, we performed patch tests with the ingredients of the cream (Table 2), kindly provided by the manufacturer (Aboca). Patch tests gave positive reactions (++), at both D2 and D4, for the hydrophilic fraction and the lipophilic fraction of flowering tops of Helichrysum (Helydol®), both at 3% pet. Ten healthy volunteers were patch tested with both substances, with negative results.