Contact dermatitis caused by lovage (Levisticum officinalis) essential oil

Essential oils are used as perfume ingredients, and also as therapeutic substances in aromatherapy.Several essential oils have been identified as sensitizers.Here, we report the first case of contact dermatitis caused by lovage. Case ReportA 31-year-old female presented with sharply demarcated, erythematous and slightly scaling patches on the flexural side of both underarms and the right shoulder (Fig. 1).The lesions started 2 weeks after application of two undiluted essential oils: fifth Chakra (mixture of Geranium spp., Boswellia carterii, Jasminum grandiflorum absolute, Pogostemon cablin, and Citrus aurantium ssp.bergamia) and Lavas (Levisticum officinalis) (both obtained from Sjankara, Belgium).The lesions healed after treatment with topical and systemic steroids.Because the lesions were suggestive of allergic contact dermatitis, patch tests were performed with the Belgian baseline series, cosmetic, fragrance and plant series, and the patient's own products (fifth Chakra and Lavas, both diluted 5% in ethanol).The patch tests were placed on the upper back, and occluded for 2 days with van der Bend ® square chambers (Van der Bend, Brielle, The Netherlands) fixed with Hypafix ® (BSN Medical, Hamburg, Germany).Readings were performed after D2 and D4, according to International Contact Dermatitis Research Group guidelines.Patch tests were positive for p-phenylenediamine (+), Myroxylon pereirae (++), sesquiterpene lactone mix (+), eugenol (+), isoeugenol (++), cananga oil (+), jasmine absolute (+), fifth Chakra (+), and Lavas (+++) (Fig. 2).