Adverse Reactions

Irritant dermatitis from calendula has been reported (Paulsen 2002, Reider et al 2001) Calendula 175

but is rare. Sesquiterpene lactones are the most important allergens present in

Compositae species, but there are a few cases of sensitisation from a coumarin, a sesquiterpene alcohol and a thiophene (Paulsen 2002).

A study of over 1000 patients randomly chosen from several different patch test clinics identified only one who reacted to calendula (Bruynzeel et al 1992). Patch test results need to be carefully interpreted because false positives can occur, as the following case shows. A 35-year-old woman with recalcitrant atopic dermatitis, with a positive patch-test reaction to Compositae mix, was told she was allergic to calendula. However, it turned out that she followed a self-devised diet consisting largely of food products of the Compositae family (which includes lettuces and artichoke). On excluding these foods her skin condition improved quickly. This case report underscores the difficulty in determining the relevance of positive patch tests, and shows that thorough analysis of positive patch tests, by both patient and physician, may reveal unexpected or less common sources of contact allergens (Wintzen et al 2003).

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