calendula and Hand-Dermatoses

The so-called hand-foot syndrome (HFS) is a dose-limiting side effect with only rare therapeutic options in cancer patients treated with capecitabine (Xeloda). Depending on the intensity of the skin reaction dose reduction, interruption or even the break-off of capecitabine therapy is necessary. We therefore try to describe a new and promising alternative treatment of the hand-foot syndrome, a local therapy with a mixture of herbal medicinal products mainly consisting of hand- and foot baths, and present the promising results of this treatment modality observed in 11 consecutive patients.

Topics: Antimetabolites, Antineoplastic; Calendula; Capecitabine; Deoxycytidine; Fluorouracil; Foot Dermatoses; Hand Dermatoses; Humans; Matricaria; Phytotherapy; Salvia; Treatment Outcome

Medical remedies of plant origin have gained increasing popularity in recent years. Both anaphylactic and eczematous allergic reactions are on the rise, accordingly. Arnica and marigold, both of the Compositae family, are in widespread use, but only limited data are available on their allergenic potential. We tested 443 consecutive patients, in addition to the European standard and other series, with Compositae mix, sesquiterpene lactone mix, arnica, marigold, and propolis. 5 subjects ( approximately 1.13%) reacted to arnica, 9 ( approximately 2.03%) to marigold. The Compositae mix was positive in 18 cases ( approximately 4.06%). Among them were 3 out of 5 individuals with a sensitization to arnica, and 4 out of 9 who reacted to marigold. Sensitization to arnica and marigold was often accompanied by reactions to nickel, Myroxylon Pereirae resin, fragrance mix, propolis, and colophonium. We conclude that Compositae allergy contributes significantly to the epidemiology of contact dermatitis and that sensitization to arnica and marigold cannot be assessed by testing with the Compositae or sesquiterpene mix alone. As extracts of these plants are frequently used in occupational and cosmetic products, patch testing with additional plant extracts or adjustment of the commercial Compositae mix to regional conditions is recommended.

Topics: Adult; Aged; Aged, 80 and over; Allergens; Arnica; Calendula; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Hand Dermatoses; Humans; Hypersensitivity, Delayed; Male; Middle Aged; Patch Tests; Plant Extracts; Plants, Medicinal; Skin