(Daisy or Sunflower family)
- Artemisia L.
This genus, which is classified in the tribe Anthemideae, comprises nearly 300 species (Kelsey & Shafizadeh 1979) that are found in northern temperate regions, southern Africa, and South America. Members of this genus are common on arid soils of the western United States and of the Russian steppes.
Some five species yield oils used in perfumery (Arctander 1960). These include Artemisia annua L., Artemisia dracunculus L., Artemisia pallens Wall., and Artemisia vulgaris L. Oil of Levant wormseed is derived from Artemisia maritima L.; oil of wormwood is derived from Artemisia absinthium L. The bitter wormwood of the Old Testament (Proverbs 5:3) is said to be Artemisia judaica L. Tarragon (Artemisia dracunculus L.) is used for flavouring a vinegar; the dried herb is frequently handled by cooks, for it is an essential ingredient of Sauce Béarnaise of high gastronomic repute.
The following taxa have been found to contain potentially allergenic sesquiterpene lactones, but have not been reported to cause dermatitis:
- Artemisia arbuscula Nutt. ssp arbuscula
- Artemisia aschurbajewi Winkler
- Artemisia austriaca Jacq.
- Artemisia balchanorum H. Kraschen
- Artemisia bigelovii A. Gray
- Artemisia campestris L. var douglasiana J. Boivin
- (syns Artemisia douglasiana Besser, Artemisia heterophylla Nutt.)
- Artemisia cana Pursh ssp cana
- Artemisia cana Pursh ssp viscidula Beetle
- Artemisia carruthii Wood
- (syns Artemisia wrightii A. Gray, Artemisia bakeri Greene, Artemisia pringlei Greenman)
- Artemisia caucasica Willd.
- Artemisia dracunculoides Pursh
- Artemisia feddei A. Léveillé & Vaniot
- Artemisia franserioides Greene
- Artemisia incana Druce
- (syn. Tanacetum incanum L.)
- Artemisia juncea Karelin & Kir.
- Artemisia klotzchiana Besser
- Artemisia lercheana Webber
- Artemisia leucodes Schrenk
- Artemisia ludoviciana Nutt. ssp albula Keck
- (syns Artemisia albula Wooton, Artemisia microcephala Wooton)
- Artemisia nova Nelson
- Artemisia princeps Pampan.
- Artemisia rothrockii A. Gray
- Artemisia rutifolia Stephan & Sprengel
- Artemisia sibirica Maxim.
- Artemisia spicata Wulfen
- (syn. Artemisia genipi Webber)
- Artemisia tridentata Nutt. ssp tridentata
- Artemisia tridentata Nutt. ssp tridentata f parishii Beetle
- Artemisia tridentata Nutt. ssp vaseyana Beetle
- (syns Artemisia tridentata Nutt. var vaseyana J. Boivin, Artemisia vaseyana Rydb.)
- Artemisia tridentata Nutt. ssp vaseyana Beetle f spiciformis Beetle
- Artemisia tripartita Rydb. ssp tripartita
- Artemisia tripartita Rydb. ssp rupicola Beetle
- Artemisia verlotorum Lamotte
Sesamin, which is known for its role in sesame oil (Sesamum indicum L., fam. Pedaliaceae) dermatitis, has been reported from the roots of the following species (Greger 1981):
- Artemisia canariensis Less.
- Artemisia gorgonum Webb
- Artemisia jacutica Drobow
- Artemisia siversiana Ehrh.
- Artemisia absinthium L.
- (syns Absinthium vulgare Lam., Absinthium officinale Brot.)
- Wormwood, Absinthe
The fresh or dried leaves or flowering tops provide the crude drug known as absinthium, the essential oil of which contains principally thujone. A tincture of absinthium is used as a bitter to flavour the beverage Absinthe and possibly also Vermouth. Habitual use of absinthium can lead to absinthism, the symptoms of which are restlessness, vomiting, vertigo, tremors, and convulsions (Wade 1977). If used as a smoke or tea, it can have relaxant and narcotic-analgesic effects (Siegel 1976, Anon 1979).
The flowers of this weed, which is common on roadsides and in old gardens, have caused a scarlatiniform eruption in sensitised persons working in its vicinity (Schwartz et al. 1957). According to Behl et al. (1966), the flowers have a greater sensitising capacity than the leaves. Four patients who had plant dermatitis showed positive patch test reactions to this plant which was a constituent of a proprietary topically applied remedy for dermatitis (Underwood & Gaul 1948).
Mitchell et al. (1971b) observed a negative patch test reaction to the plant in a patient with contact sensitivity to other Artemisia L. species and some other members of the Compositae. Hausen & Osmundsen (1983) reported a positive patch test reaction to an extract of wormwood (10% in petrolatum) in a hobby gardener who was sensitised to feverfew (Tanacetum parthenium Schulz-Bip.) and cross-sensitive to 8 other members of the Compositae as well as to the liverwort Frullania dilatata Dum. (fam. Jubulaceae) and Laurus nobilis L. (fam. Lauraceae).
Frain-Bell & Johnson (1979) observed positive patch test reactions to the oleoresin from this species in 10 from 55 patients with the photosensitivity dermatitis and actinic reticuloid syndrome.
The fragrance raw material known as artemisia oil or wormwood is produced by steam distillation of the plant. It was found to be slightly irritating to rabbit skin when applied under occlusion for 24 hours. When diluted to 2% in petrolatum, it was non-irritant (48 hour closed patch test) and non-sensitising (maximisation test) in 25 human volunteers. Also, no phototoxic effects from the undiluted oil could be detected in mice or swine (Opdyke 1975, p. 721).
Sesquiterpene lactones have been isolated from this species (Yoshioka et al. 1973, Fischer et al. 1979), but all lack the exocyclic methylene group on the lactone ring that is usually associated (Mitchell & Dupuis 1971) with contact allergenicity in this class of compounds.
- Artemisia afra Jacq.
This plant is one of the most widely used of herbal remedies in southern Africa. Any irritant effects from it are probably due to camphor which is present in the volatile oil from the plant (Watt & Breyer-Brandwijk 1962).
- Artemisia annua L.
- (syn. Artemisia chamomilla C. Winkl.)
- Annual Wormwood, Sweet Annie, Sweet Wormwood
The plant has a long history of use in China for its antifebrile properties. It is the source of the crude drug known as Qing Hao or Herba Artemisiae Apiaceae. Artemisinin, a sesquiterpene lactone known in Chinese as Qinghaosu, has been isolated from the plant and found to have antimalarial properties (Bruce-Chwatt 1982, Xaio 1983). It lacks the structural features (Mitchell & Dupuis 1971) that are normally associated with contact allergenicity in this class of compounds. However, the potentially allergenic arteannuin B (a cadinanolide) has been reported from this species (Kelsey & Shafidazeh 1979).
- Artemisia arborescens L.
According to Merzouki et al. (2000), the powdered leaf is used in NW Moroccan traditional medicine as an external application in the treatment of cutaneous infections and wrinkles.
Sesamin, which is known for its role in sesame oil (Sesamum indicum L., fam. Pedaliaceae) dermatitis, has been reported from the roots of this species (Greger 1981).
- Artemisia arctica Less.
- Artemisia biennis Willd.
- Artemisia campestris L. ssp borealis H.M. Hall & Clements
- (syn. Artemisia borealis Pallas)
- Artemisia norvegica Fries
- Artemisia trifurcata Stephan
Mitchell et al. (1971b) observed a negative patch test reaction to each of these species applied "as is" in a patient who showed contact sensitivity to five other Artemisia L. species and certain other members of the Compositae.
- Artemisia californica Less.
Rowe (1939) observed a 4+ patch test reaction to this species in a patient with dermatitis from Xanthium spinosum L.
A potentially allergenic eudesmanolide has been reported from this species.
- Artemisia cina Berg
Santonin is a crystalline lactone obtained from the dried, unexpanded flowerheads of this and several other species of Artemisia, but is restricted almost exclusively to the sub-genus Seriphidium (see Kelsey & Shafidazeh 1979). It was formerly used as an anthelmintic in the treatment of ascariasis (Wade 1977).
Harrison (1906) included santonin in a list of drugs, applied externally or taken internally, which may cause dermatitis.
- Artemisia dracunculus L.
The fragrance raw material known as tarragon oil or estragon oil is distilled from the leaves, stems, and flowers of this species. The oil was found to be irritant when applied to the skin of rabbits and mice. However, when applied at a dilution of 4% in petrolatum, no irritancy was observed in a 48 hour closed patch test, and no sensitising properties could be demonstrated in a maximisation test on 25 human volunteers. The oil was also not phototoxic (Opdyke 1974, p. 709).
- Artemisia lindleyana Besser
Mitchell et al. (1971b) observed a severe, delayed patch test reaction to this plant in a patient with contact sensitivity to Artemisia ludoviciana Nutt. and three other Artemisia species.
- Artemisia ludoviciana Nutt. ssp ludoviciana
- (syns Artemisia ludoviciana Nutt., Artemisia ludoviciana Nutt. ssp typica Keck, Artemisia vulgaris L. var ludoviciana Kuntze, Artemisia purshiana Besser)
- White Sagebrush, Prairie Sage
Contact sensitivity to prairie sage was reported by Brunsting & Anderson (1934), and has been observed by one of the authors (A.J.R.) in a professional gardener. Of 25 patients with "weed dermatitis", 17 showed positive patch test reactions to this plant with cross-sensitivity to other members of the Compositae (Mackoff & Dahl 1951). Mitchell et al. 1971b) also observed a severe, delayed positive reaction to a patch test with the plant material in a patient who was sensitive to four other Artemisia species as well as to ludovicins A, B, & C, eupatoriopicrin, artemorin acetate, and parthenolide.
This taxon does not appear to have been studied phytochemically. Moreover, because of the confusion in the taxonomy and nomenclature of plants described loosely as Artemisia ludoviciana or Artemisia mexicana, reports of allergic contact dermatitis from these plants should be interpreted with caution unless plant material has been adequately authenticated.
- Artemisia ludoviciana Nutt. ssp mexicana Keck
- (syns Artemisia mexicana Willd. ex Sprengel, Artemisia neomexicana Greene, Artemisia vulgaris L. var mexicana Torrey & Gray)
- Mexican Mugwort, White Sagebrush
None of 50 patients with "weed dermatitis" showed positive patch test reactions to an extract of this plant (Shelmire 1939a).
Ludovicin A, a sesquiterpene lactone found in this taxon (Yoshioka et al. 1973), has been shown to elicit contact dermatitis in two patients, one of whom was found to be sensitive to five species of Artemisia (Mitchell et al. 1971b).
- Artemisia michauxiana Besser
- (syn. Artemisia vulgaris L. ssp michauxiana St John)
- Michaux's Wormwood
Mitchell et al. (1971b) observed a strongly positive patch test reaction to this plant in a patient who was sensitive to four other Artemisia L. species.
- Artemisia pallens Wall.
A fragrance raw material known as davana oil is prepared by steam distillation of the plant material. The oil was found to be moderately irritant to rabbit skin when applied under occlusion for 24 hours. At a dilution of 4% in petrolatum, the oil was found to be non-irritant in a 48 hour closed patch test and non-sensitising in a maximisation test carried out on 33 human volunteers. Also, no phototoxic effects could be demonstrated in mice and swine (Opdyke 1976, p. 737).
- Artemisia tilesii Ledeb. ssp typica Keck
- (syn. Artemisia tilesii Ledeb.)
The Yupik eskimos of south-west Alaska have applied the boiled pulp of the fresh leaves of this plant to skin infections, with success against impetigo and some other diseases (Overfield et al. 1980).
Mitchell et al. (1971b) observed a negative patch test reaction to this plant in a patient who was sensitive to five other Artemisia L. species.
The plant has been reported to yield the guaianolide sesquiterpene lactones matricarin and desacetylmatricarin (Yoshioka et al. 1973). These compounds lack the exocyclic methylene group on the lactone ring that is normally associated with contact allergenicity (Mitchell & Dupuis 1971) in this class of compounds but, nevertheless, desacetylmatricarin has produced positive patch test reactions in a sesquiterpene lactone-sensitive patient (Mitchell JC 1973 — unpublished observation).
- Artemisia vulgaris L.
- Common Mugwort, Felon Herb, Common Wormwood, Wild Wormwood, St John's Plant
In Japan and China (Oda 2000, Remington et al. 1918, Stuart 1911), moxa are made from the leaves or the downy hairs on the leaves and stems of one or more species of Artemisia L. or Crossostephium Less., including:
- Artemisia argyi H. Lév. & Vaniot
- (syns Artemisia chiarugii Pampan., Artemisia vulgaris L. var incana Maxim.)
- Artemisia montana Pampan.
- Artemisia moxa DC.
- Artemisia princeps Pampan.
- Artemisia vulgaris L.
- Artemisia vulgaris L. var indica Maxim.
- (syn. Artemisia indica L.)
- Crossostephium chinense Makino
- (syns Artemisia chinensis L., Tanacetum chinense A. Gray ex Maxim., Chrysanthemum artemisioides Kitam.)
Moxa are small combustible masses used to produce an eschar by being burned in contact with the skin. This form of therapy, which is used for both cauterising and counterirritant purposes, is known as moxibustion. The first sensation experienced is not disagreeable; but the operation becomes gradually more painful, and towards the close is for a short time very severe (Remington et al. 1918).
In Chinese traditional medicine, the plant material is known as Ai Hao, Ai Ye, or simply as Ai, the distinction between botanical species being unimportant from the medical standpoint. The dried and processed plant material used as a moxa is known as Ai Jung (Stuart 1911).
Condé-Salazar et al. (1991) described in outline the principles underlying the use of moxibustion and its relationship with acupuncture, and documented a case of a patient who presented with numerous burns of the hand and wrist following (reportedly successful) moxibustion therapy for "tennis elbow". Chua et al. (2015) reported erythema ab igne and dermal scarring caused by cupping and moxibustion.
Both the expressed juice of the fresh plant and a decoction prepared from the plant may also be used in Chinese traditional medicine as an application or wash respectively in the treatment of wounds and ulcers. In addition, the leaves may be steamed and used as a poultice to relieve pain, this preparation being known as Ai Pa (Stuart 1911).
Artemisia vulgaris is listed by Mackoff & Dahl (1951) as a cause of "weed dermatitis". A male, aged 44 years, developed severe dermatitis from applying a decoction of the plant to the skin and drinking a tea made of it (Kurz & Rappaport 1979).
Hausen (1979) observed two patients with weakly positive (1+) patch test reactions to mugwort who were very sensitive to Chrysanthemum indicum. Kaupinnen et al. (1980) noticed that mugwort elicited positive patch test reactions in all of 14 patients who suffered from severe attacks of angio-oedema and urticaria caused by celery (Apium graveolens L., fam. Umbelliferae) and parsley (Petroselinum crispum Fuss, fam. Umbelliferae).
The fragrance raw material known as armoise oil is distilled from the leaves and flowering tops of this species. The oil was found to be slightly irritating when applied to rabbit or guinea pig skin under occlusion for 24 hours. At a dilution of 12% in petrolatum, no irritancy (48 hour closed patch test) nor sensitising ability (maximisation test) could be demonstrated in 24 human volunteers. Also, no phototoxic effects could be demonstrated in mice nor swine (Opdyke 1975, p. 719).