Toxalbumin exposures: 12 years' experience of U.S. poison centers

BACKGROUND

Toxalbumins are natural plant toxins purported to be highly toxic. The purpose was to evaluate toxalbumin exposures reported to U.S. poison centers to determine plants involved and their toxicities.

METHODS

A retrospective review of National Poison Data System data on acute toxalbumin exposures with known outcomes from 2000 through 2011 was performed.

RESULTS

There were 1164 exposures. The majority involved one route (1135; 97.5%), mostly ingestions (904; 79.7%) or dermal (166; 14.3%). Most patients developed no effects (694; 59.6%) or minor effects (374; 32.1%). Moderate or major effects occurred in 8.3% with 66.6% ingestions and 23.9% dermal. There were no deaths. Exposures to the plants Ricinus communis and Robinia pseudoacacia were most common (33.8% and 32.9%, respectively), with gastrointestinal effects from R. communis (vomiting 19.6%, diarrhea 8.9%, nausea 7.9%) and dermal effects from R. pseudoacacia (puncture 28.7%, dermal irritation/pain 27.9%, and edema 13.3%).

CONCLUSIONS

While toxalbumin plant exposures were generally well-tolerated, continued evaluation of risk is warranted since plants were primarily identified by the public. Major effects occurred in under 1% of cases overall, and not at all following unintentional ingestions. These findings should help allay concerns that unintentional ingestions of toxalbumin plants by young children will cause serious toxicity and possibly death.

[Vulvar pruritus: determination of the most common causes and their treatments]

Vulvar pruritus can be caused by a wide spectrum of diseases, that depend on age, environmental and genetic factors. The most common causes are candidiasis, contact dermatitis and lichen simplex chronicus. Candidiasis is the most common cause of acute vulvar pruritus and is characterized by burning, itching and vaginal whitish secretion. Contact dermatitis is caused by irritants or allergens that are in contact with the genital area, which causes imbalance in the skin barrier causing irritation, swelling, burning, among other manifestations. Lichen simplex chronicus is characterized by lichenification (thickening of the skin) secondary to the chronic itch-scratch cycle in vulvar area. It is an illnes with a tendency to chronicity, but with topical corticosteroids treatment usually might be controlled. Prompt treatment, multidisciplinary and careful attention to irritants and secondary infections prevent these entities become an important and permanent problem.

Dermal Toxicity of Flake-Like α-Alumina Pigments

Aluminum is one of the most widely used nonferrous metals and an important industrial material, especially for automotive coatings. However, potential toxicity caused by aluminum in humans limits the used of this metal. α-alumina is the most stable form of aluminum in various phases. Although the results of studies evaluating the dermal toxicity of α-alumina remained unclear, this compound can still be used as a pigment in cosmetics for humans. In the current study, we further evaluated the dermal cytotoxic effects of α-alumina on human skin cells and an in vivo mouse model. We also measured the in vitro penetration profile of flake-like α-alumina in porcine skin and assessed the degree of cellular metabolic disorders. Our findings demonstrated that treatment with flake-like α-alumina did not significantly affect cell viability up to 24 h. This compound was found to have a non-penetration profile based on a Franz modified diffusion cell assay. In addition, flake-like α-alumina was not found to induce dermal inflammation as assessed by histology of epidermal architecture, hyperplasia, and the expression of Interleukin-1β and Cyclooxygenase-2. Results of the cellular metabolic disorder assay indicated that flake-like α-alumina does not exert a direct effect on human skin cells. Taken together, our findings provided not only evidence that flake-like α-alumina may serve as a pearlescent pigment in cosmetics but also experimental basis utilizing α-alumina for human application. Our results also obviously provide new insight of the further toxicity study to aluminum based nanoparticles for skin.

N-acetylation of aromatic amines: implication for skin and immune cells

Frequently, aromatic amine (AA) contact to the skin occurs via occupational or 'life style' exposure to hair dye intermediates and couplers, usually monocyclic p-phenylenediamines and meta-substituted aminophenols. The transport of AA from the outer surface to the systemic circulation predominantly follows the intracellular route. Skin tends to have relatively higher phase II compared to phase I xenobiotic metabolizing enzyme capacity, and levels are generally regarded as lower than those in liver. Inside skin cells AA are primarily N-acetylated and detoxified by N-acetyltransferase 1. AA activation via hydroxylation or chemical oxidation competes with acetylation and is only of importance under circumstances when N-acetylation capacities are limited. The reactive AA derivatives are able to elicit effects by virtue of their modifications of skin proteins resulting in irritant or allergic contact dermatitis. Overall, the effective acetylation of topically applied AAs in skin cells emphasizes a protective role of cutaneous acetylation mediating a classical "first-pass" effect, which attenuates systemic exposure.