INTRODUCTION

Duringmixing,loadingandapplicationofpesticides,theskinisthemostlikelybodysurfacetocomeintocontactwiththe
product.Manypesticidescanbeabsorbedthroughtheskinintotheblood,andcancausetoxiceffects.Theamountof
pesticideabsorbedthroughtheskin(percutaneousabsorption)maybeenoughtoproduceseveretoxicreactionsincluding
death.Inaddition,pesticidescanalsoinjuretheskindirectly,aprocessknownascutaneoustoxicity.Skinirritationandskin
rashesproducedbyirritatingchemicalsubstancesareaverynoticeabletypeofchemicaltoxicity.Skininfectionsbyfungi
(ringworm,athlete'sfoot,etc.),bacteria,orparasitesarealsoverycommonmedicalproblemsandoftenhavethesame
symptomsasskinirritationcausedbychemicalexposure.Weliveinaworldfilledwithsubstanceswhichcanbeirritatingto
ourskin,andweusemanyoftheseirritatingsubstanceseverydaywithoutgreatconcern,becausewehavelearnedhowto
restrictourexposure.
Theskinandthemucousmembraneswhichcovertheopeningsofourbodiestotheexternalenvironment(suchasinthe
noseandmouth),formprotectivebarrierswhichkeepwaterinsidethebody,andkeeptheoutside(filledwithbacteria,
fungi,dust,dirt,etc.)fromcomingin.Theskinisreallyanorganofthebody,andalargeoneatthat.Theskinismuchmore
thanjustasimplecovering,itismultilayered,andunderneaththesurface(whichiscomposedofdeadcells),areother
layerscomposedoflivingcellswhichreacttoirritantswhentheygetthrough.Whenanirritantreachesthesesensitivelive
skincells,theycanonlyrespondinalimitednumberofways,thefirstofwhichisageneralresponsetoanyirritating
chemicalorphysicalagent(likesunlight)inflammation.Inflammationhasfourcomponentsredness,pain,heatand
swelling.Thedegreeofinflammationisadirectresultofthedegreeofchemicalorphysicalirritation(doseresponse).Ifthe
damageisgreatenoughtocausecelldeath,thentheresponsewillbemuchmoresevere,andcanresultinareasoftheskin
becoming"denuded"(lossofthelayers,withthedeeperlayersbeingexposedtothesurface).Becausetheresponseofthe
skintomanydifferentphysicalandchemicalirritantsissimilar,thecausesofskinirritationmustusuallybediagnosedbya
physicianwhospecializesinskinproblems(adermatologist).
ThisToxicologyInformationBrief(TIB)describesoneofthemostcommontoxicaffectsproducedbypesticidesandother
chemicals,cutaneoustoxicityinitsmanyforms.Cutaneoustoxicreactionsaccountforapproximately1/3ofallpesticide
relatedoccupationalproblems,howeverpesticidesarenottheonlychemicalswhichcancauseskintoxicity.Forexample,
allergicdermatitisproducedbypoisonoakisthemostfrequentcauseoftemporarydisabilityinforestryworkers.Dermatitis
meansliterally"inflammationoftheskin."Mostoftendermatitisisreferredtoasaskin"rash,"however,thistermisvery
nonspecific.Therearemanydifferenttypesof"rashes"andtheydifferquiteabitinthewaytheyappearandinhowthey
areproduced.
Someofthemorefrequentlyencountereddermatitisproblemsinhumansandfoodanimalsareprimaryirritantdermatitis
andallergiccontactdermatitis.

PRIMAR YIRRITANTDERMATITIS
Thistypeofdermatitisiscausedbychemicalsubstancesthatdirectlyirritatetheskin(likecausticacidsorbases).The
symptomsmaybesimilartoaslightburn(redness,itching,pain)orassevereasblisters,withpeelingandopenwounds
(ulcerations).Theareasofdirectcontactareusuallythemostaffectedandthisisoneofthewaysitisrecognized.Treatment
consistsofremovaloftheirritantbywashingandpreventionoffurthercontactwiththechemical.Steroidcreams(suchas
0.5%hydrocortisonepreparations,availablewithoutprescription)mayhelpalleviatepainanditching.Whenexposuretothe

irritantispreventedtheirritationcannotoccur.Thus,theuseofappropriateprotectiveequipmentcancompletelypreventthe
developmentofprimaryirritantdermatitis.
Table1.Thefollowingplantsandpesticides
maycauseprimaryirritantdermatitis.
Pesticides
Sulfur
Captafol
Endosulfan
Omite
Folpet
Lindane
Ziram
Thiram
Zineb

Toxaphene
Methomyl
Dinoseb

Chloropicin
Kelthane
Triazine

Maneb
Captan
WeedOil
Chlorothalonil
Plants
Tomatoes

Dinitro
Benomyl
TOK
Glyphosate
Dacthal
Organophosphates
Flowers
Trees
Dieffenbachia
RubberTree

Carrot
Mushroom

CastorBean
Daffodil

Cucumber
Parsnip
Turnip

Buttercup
Foxglove
Tulipbulb

Parsley
Celery
Cowslip
Milkweed

Narcissusbulb

FigtreeSap

ALLERGICCONTACTDERMATITIS
Thebestexampleofallergiccontactdermatitis(ACD)ispoisonoakandpoisonivydermatitis.Thiscutaneoustoxic
reactionisatrueallergicresponsebecausetheskinmustbesensitizedbyexposuretothechemical(onceormanytimes)and
theresultisalocalizedallergicreaction.NoteveryonewilldevelopACDafterexposure,andsomeworkersmayhandlea
potentiallyallergenicsubstanceforyearsbeforeACDdevelops,oritmaydevelopafterasingleexposure.Thesymptomsof
ACDareexactlythoseofpoisonivyorpoisonoakdermatitis,andvaryfromredness,itchingandsmallblistersto
widespreadblistersthatoverlapformingverylargefluidfilledblisters.Treatmentinvolvesthoroughwashingtoremovethe
allergen(inthecaseofpoisonivyandoakitistheoilsintheplants)followedbytreatmenttoreducetheitching,painand
swelling.Atopicalcorticosteroidcreammaybeveryeffectiveinreducingthesymptoms.Whenlargeblistersbreakorare
opened,careshouldbetakentopreventsecondaryinfectionoftheserawareas.Localanestheticcreams(containing
benzocaine)shouldbeavoidedsincetheyalsocanactascontactsensitizers(mayalsocauseallergicdermatitis)andmay
alsodelayhealing.
Table2.Theseplantsandpesticidesmaycauseallergic
contactdermatitis(ACD).
Pesticides
Captan
Captafol
Benomyl
Triazine
Dichlorovos
Parathion
Malathion
naled
Thiram

PCNB
TOK
Maneb
Cresol
Somenaturalpyrethroides
Plants
Flowers
PoisonIvy
PoisonOak
PoisonSumac
Liverwort
Onions
Garlic

Primrose
EnglishIvy
Tulipbulbs
Chrysanthemum
NarcissusBulbs

Zineb
Formaldehyde
Trees
Cedar
Pine
Cashew
Lichens

Celery

PHOTOSENSITIZATIONDERMATITIS
Therearetwobasictypesofphotosensitizationdermatitis.Thefirst,whichismostcommoninnonhumans,iscalled
phototoxicphotosensitizationdermatitis.Phototoxicityisnotverycommoninhumanswhereasindomesticfoodanimalsit
isthemostcommoncutaneoustoxicresponse.Phototoxicphotosensivityoccurswhenacompound(aphotosensitizer)is
presentinthebodymakingtheorganismsensitivetosunlight.Theconditionofphototoxicityoccursonlyafterexposureto
sunlight.Signsofphototoxicityaresunburnlikereactionsespeciallyinnonpigmentedareas.Someoftheconditionsand
plantswhichcausephototoxicphotosensitizationinnonhumansarelistedintable3.
Table3.Plantsandconditionsthatmaycausephotosensitizationwheningested.
Plants
Conditions
Tetradymiasp(Horsebrushes) Phenothiazines
Lecheguilla
Sulfonamides
Lantana
Kochia
Tribulusterrestris(Goatshead)
Hypericiumsp.(StJohnswort)

Tetracyclines
Otherdrugs
CopperToxicosisinSheep
Bluegreenalgaepoisoning
Anyconditionthatseriouslydamagestheliver(pyrrolizidinealkaloidpoisoning).

Contactphototoxicphotosensitizationisthemostcommonoccupationalphototoxicreactioninhumans,andiscaused
primarilybyplants.Thistypeoftoxicreactionoccurswhenthephotoactivechemicalproducedbytheplant(orfungus)
contactstheskin,isabsorbedintotheskin,andthenactivatedbysunlight.Theresultisthesameassunburn,andvariesin
intensitydependentontheamountofchemicalexposure,andtheamountofexposuretosunlight.Plantswhichcauseitare
listedintable4.
Table4.Plantswhichcausecontactphoto
sensitization.
Figs
Parsley
Carrots
Dill
Lime
Buttercup
Mustard(withpinkrot) Klamathweed Celery
Thesymptomsareredness,pain,blisteringand,followingrecovery,hyperpigmentationoftheaffectedarea.Historians
recordthattheancientEgyptiansknewofthisreactionandusedittodarkenlightareasoftheskin.Someformsoftoxic
chemicalsfromplantsarestillusedtodaytotreathypopigmentation(abnormallylightpigmentationoftheskin).
Thesecondtypeofphotosensitizationdermatitisisthephotoallergicreaction.Thisdisorderisverysimilarinappearanceto
allergiccontactdermatitishowever,sunlightisrequiredtoinitiatetheprocess.Itrequirespriorexposuretothechemical

andsunlight,andisnotverycommon.

SUMMARY
Chemicalscanbeabsorbedthroughskinandintothebloodstreamcausingtoxiceffects.Thechemicalsmayalsocause
reactionsontheskinsurface.Someindividualsmaybeparticularlysensitivetoacompoundoraplantandothersmay
experiencelittleornoeffectsfromcontact.Determiningthecauseofdermatitismaybeeasyoritmaybedifficult.IfIknew
IwalkedthroughpoisonivyandIdevelopareaction,theconnectionisfairlyobvious.However,ifIhaveworkedinthe
garden,ortheexterminatorvisitedaweekagoandIhavedevelopedarashtheconnectionsarenotasobvious.
Findingoutjustwhathascausedthedermatitismayinvolve"patchtesting"inwhichthepatient'sskinisexposedtosmall
patchescontainingdilutesolutionsofthesuspectagents.Inthisway,theoffendingchemicalcanbeidentifiedandmeasures
takentopreventorminimizefutureexposure.Thebestwaytopreventcutaneoustoxicityistheappropriateandcorrectuse
ofprotectiveclothing,andtheuseofsafehandlingandapplicationprocedures.