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   Index



 

CACTACEAE

(Cactus family)

 

The cactus family comprises perhaps 2000 species in 50–15 genera (the classification of the family is more than usually controversial). The plants are distinctive, often spiny, succulents most of which occur naturally in the arid regions of the Americas. Several species of Opuntia Mill. have been introduced into Australia, South Africa, India, and the Mediterranean region where they have naturalised and have often become troublesome as weeds.

Cacti are popularly grown and cultivated as house and greenhouse plants. They may easily be confused with certain cactiform species in the family Didiereaceae and more importantly with some Euphorbia L. species in the family Euphorbiaceae. Members of the genus Euphorbia differ from cacti in not having areoles at the spine bases [see below] and in having a white milky latex which in many cases has powerful skin irritant properties. These Euphorbia species are, furthermore, commonly grown in collections of succulents alongside cacti. The use of the term cactus in describing a cactus-like plant should therefore be accepted with scepticism, especially if an irritant (but not mechanical) dermatitis is suspected.

The red food colouring, cochineal, is obtained from certain beetles (Dactylopius coccus Costa, 1835 and related species, fam. Dactylopiidae) that are cultivated on Opuntia species.

The dumpling cactus (Lophophora williamsii J.M.Coult., syns Anhalonium williamsii Rümpler, Echinocactus williamsii Lemaire) is the source, when dried, of peyote or mescal buttons. These have been utilised in American Indian ceremonies for very many years as orally active hallucinogens. Mescaline is the main active constituent; it also occurs in some other species of cactus.

The fruits of certain Opuntia species, including Opuntia ficus-indica Mill. and Opuntia humifusa Raf. (syn. Opuntia vulgaris Mill.), are edible. They are known as Indian figs and prickly pears respectively, although the former name is often used loosely in place of the latter.

Many, but not all, cacti are capable of inflicting mechanical injury. This may be the result of penetration of the skin either by one or more erect spines, or by glochids — tufts of short, barbed or hooked hairs arising from pin-cushion like structures named areoles, from which the larger spines, if present, also arise. Eye injuries have also been recorded (Biger & Abulafia 1986). Glochids are a hazard of genera belonging to the tribe Opuntieae in particular (including Pereskiopsis Britton & Rose, Pterocactus K.Schum., Tacinga Britton & Rose, Opuntia Mill., and Nopalea Salm-Dyck), and especially the spineless species. There is reason to believe that an allergic reaction may occur when glochids or spines enter the skin, possibly from fungal contaminants. No attempt has been made to list here all species that may be capable of causing mechanical injury.


Acanthocereus pentagonus Britton & Rose
[syn. Cereus pentagonus Haw.]

This species is listed as a cause of mechanical injury (Oakes & Butcher 1962). Other species doubtless share this property.



Aporocactus flagelliformis Lemaire
[syn. Cereus flagelliformis Mill.]
Rat's Tail Cactus

The plant is used in Mexico as a rubefacient (Díaz 1976).



Lemaireocereus eruca Britton & Rose
[syn. Cereus eruca Brandegee]

Wimmer (1926) referred to the spines of this species as a possible cause of mechanical injury.



Nopalea coccinellifera Salm-Dyck
[syn. Opuntia cochinelifera Mill.]
Cochineal Plant, Red Sabra, Monkey Fiddle, French Prickly Pear

The glochids from this species can produce "sabra dermatitis" (Shanon & Sagher 1956). See also Opuntia ficus-indica Mill.



Opuntia Mill.

The spines, especially the glochids, may produce infected sores of the face, mouth, tongue, throat, and gastric mucosa in man and grazing animals. The glochids are minute and barbed, and produce considerable irritation and itch on penetrating the skin. If an attempt is made to suck out the glochids from the skin, they are likely to attach themselves to the tongue. They may be removed by spreading an adhesive plaster over the area and ripping it off quickly (Watt & Breyer-Brandwijk 1962). Melted wax may also be used (Shanon & Sagher 1965).

In Africa, the plants are placed outside houses as "burglar alarms" (Irvine 1961).



Opuntia engelmannii Salm-Dyck var. lindheimeri Parfitt & Pinkava
[syn. Opuntia lindheimeri Engelm.]
Texas Prickly Pear

The spines from this and related species of Opuntia are frequently found in the tongues of range cattle in the southeastern USA, often predisposing the tongue to bacterial infection. A similar disorder has been reported in sheep (Migaki et al. 1969).



Opuntia ficus-indica Mill.
[syn. Cactus ficus-indica L.]
Indian Fig Cactus, Common Sabra, Yellow Sabra

Occupational dermatitis from gathering the fruit of this species has long been recognised (Rossiter 1924, Cavallucci 1930). An outbreak in the Mediterranean region was described by Shanon & Sagher (1956a, 1956b, 1965, 1969). Glochids entering the skin of workers engaged in gathering the fruits of the plant produced lesions of the skin between the fingers. Any part of the skin could be affected, producing a condition resembling scabies. The glochids were transferred to the workers' clothing and thence to other individuals. The hard palate and tongue were occasionally affected. The prickly pear should be picked only when wetted, and picking should be stopped when it is windy since the glochids can become airborne. Shanon & Sagher (1956) could reproduce in the laboratory the effects of the glochids on the skin. Patch tests showed that allergenicity was not involved. A further case has been reported by Banerjee (1977).

One of the authors (AJR) has seen extensive sabra dermatitis of the back and thighs in a holiday maker who fell into a "prickly pear" (an unidentified Opuntia Mill. species) in Majorca.

According to Behl et al. (1966), the sap of the plant is irritant and can produce eczematous dermatitis.



Opuntia microdasys Pfeiffer
[syn. Cactus microdasys Lehmann]
Bunny's Ears

This species is popularly grown in homes and greenhouses. The glochids cause intense irritation (Behl et al. 1966). Two cases of dermatitis and keratoconjunctivitis caused by the glochids were described by Whiting & Bristow (1975).

The name Opuntia macrodasys is occasionally encountered. This is of no botanical standing, and appears to be a misspelling of Opuntia microdasys.



Opuntia rafinesquii Engelm.

Wimmer (1926) refers to the glochids of this species as a possible cause of mechanical injury.



Opuntia robusta Wendl.

The glochids produced an eruption of the skin on the left arm and left thigh. The forced warm-air system of the house blew the glochids into the clothing covering these sites (Kirsch 1958).



Phyllocactus phyllanthus Link

In its natural habitat, this tropical American epiphytic species grows on "ant gardens" within which nest various species of biting and stinging ants (Wheeler 1921).



Selenicereus grandiflorus Britton & Rose
[syns Cereus grandiflorus Mill., Cactus grandiflorus L.]
Queen of the Night

Application of the crude drug to the skin caused pruritus, pustules, and excoriations (Piffard 1881). In Cuba, the juice of the stems is used as a vermifuge and as a vesicant (Morton 1981).



MECHANICAL INJURY

Cactus spines can cause mechanical injury. The Mexican Aztecs of about 1200–1600 A.D. ritually impaled victims on the tops of spiny cacti (Rowley 1960). Deep penetration of a cactus spine can produce a mass resembling sarcoma (Costa 1943) or pseudotuberculous lesions of bone (Warthin & Davies 1924, Barney 1925). Buhr (1960), citing Boyd 1955, noted that cactus spines can produce foreign-body granulomas that may requires surgical attention. Gougerot & Eliascheff (1930) described a chronic subcutaneous nodule that was produced by an unidentified spine. Other local toxic effects from cactus spines were described by Hauffe (1926), Löwy (1926), Glass (1927), and Stein (1928). Sutton, in discussion of Lain (1918), described a disorder that was comparatively common in the arid regions of the western United States, most of those affected being gasoline tractor drivers. The eruption was confined to the skin of the limbs, and resulted from spines of cactus plants breaking off under the skin; secondary infection and skin ulceration were common. Karpman et al. (1980) have suggested that contaminating fungal material may be responsible for the often observed inflammatory reactions following cactus spine injuries.

Glochids entering the skin can also produce granulomatous reactions (Winer & Zeilenga 1955) which may be toxic and allergic. Since such reactions are uncommon compared with the large number of cactus injuries suffered in Arizona, USA, an allergic mechanism was postulated by Schreiber et al. (1971). They observed positive delayed skin test reactions to intradermal injections of extracts of glochids in two-thirds of affected patients.


References

  • Banerjee K (1977) A case report of sabra dermatitis. Indian Journal of Dermatology 22(4): 159-162.
  • Barney RE (1925) Cactus spine pseudotubercule. Archives of Dermatology and Syphilology 11: 331.
  • Behl PN, Captain RM, Bedi BMS, Gupta S (1966) Skin-Irritant and Sensitizing Plants Found in India. New Delhi: PN Behl [WorldCat]
  • Biger Y, Abulafia C (1986) [Eye injuries due to cactus thorns]. Harefuah 110(12): 611-612
  • Boyd W (1955) Pathology for the Surgeon, 7th edn. Philadelphia: W.B. Saunders Company
  • Buhr AJ (1960) The thorn in the flesh. The Lancet 275(7119): 309-310 [doi] [url] [pmid]
  • Cavallucci U (1930) Di une dermatite professionale da spine di fico d'India. Rinasc. Med. 7: 90-xx.
  • Costa AJ (1943) Lesion cavernosa de condilo femoral interno, producida por espina de cactus. Prensa Méd., La Paz 3: 44.
  • Díaz JL (1976) Usos de las Plantas Medicinales de México. México: Instituto Mexicano para el Estudio de las Plantas Medicinales [WorldCat]
  • Glass E (1927) Klinisch-experimenteller Beitrag zu den Verletzungen durch Kakteenstacheln. Arch. Klin. Chir. 145: 658.
  • Gougerot H and Eliascheff O (1930) Nodule chronique hypodermique par corps etranger non irritant (epine). Archs Dermato-Syph. Clin. Hôp. S-Louis : 162.
  • Hauffe (1926) Medizinische Klinik 22: 16. Cited by Touton (1932)
  • Irvine FR (1961) Woody Plants of Ghana. With special reference to their uses. London: Oxford University Press [doi] [WorldCat] [url] [url-2]
  • Karpman RR et al. (1980) Cactus thorn injuries to the extremities: their management and etiology. Ariz. Med. 37: 849.
  • Kirsch N (1958) An unusual case of contact dermatitis. Conn. Med. 22: 756.
  • Lain ES (1918) Dermatitis Lycopersicum esculentum (tomato plant). Journal of the American Medical Association 71(14): 1114-1117 [doi] [url] [url-2]
  • Löwy J (1926) Über eine lokale Toxikose nach Verletzung mit Kakteenstacheln. Medizinische Klinik 22: 290.
  • Migaki G, Hinson LE, Imes GD, Garner FM (1969) Cactus spines in tongues of slaughtered cattle. Journal of the American Veterinary Medical Association 155(9): 1489-1492 [pmid]
  • Morton JF (1981) Atlas of Medicinal Plants of Middle America. Bahamas to Yucatan. Springfield, IL: Charles C Thomas [WorldCat]
  • Oakes AJ, Butcher JO (1962) Poisonous and Injurious Plants of the U.S. Virgin Islands. Miscellaneous Publication No. 882. Washington, DC: Agricultural Research Service, United States Department of Agriculture [WorldCat] [url] [url-2]
  • Piffard HG (1881) A Treatise on the Materia Medica and Therapeutics of the Skin. New York: William Wood & Company [WorldCat] [url] [url-2]
  • Rossiter CB (1924) Dermatitis due to hairy caterpillar. British Medical Journal ii(3326; Sep 27): 604 [doi] [url]
  • Rowley GD (1960) A short history of succulent plants. In: Jacobsen H (Ed.) A Handbook of Succulent Plants. Vol. 1. pp. 1. London: Blandford Press.
  • Schreiber MM, Shapiro SI and Berry CA (1971) Cactus granulomas of the skin. An allergic phenomenon. Archives of Dermatology 104: 374.
  • Shanon J and Sagher F (1956a) Sabra dermatitis. Harefuah 51: 271.
  • Shanon J and Sagher F (1956b) Sabra dermatitis. An occupational dermatitis due to prickly pear handling simulating scabies. AMA Archives of Dermatology 74: 269-275.
  • Shanon J and Sagher F (1965) Sabra dermatitis. Dermatite professionale causata da contatto con fico d'India che assomiglia alla scabbia. [Sabra dermatitis. Occupational dermatitis caused by contact with the prickly pear which resembles scabies]. Dermatologia Internationalis 4(2): 125-127
  • Shanon J and Sagher F (1969) Sabra dermatitis. An occupational dermatitis simulating scabies due to the handling of prickly pears. In: Simons R and Marshall J (Eds) Essays on Tropical Dermatology. pp. 85. Amsterdam: Excerpta Medica.
  • Stein RO (1928) Eigentümlich verlaufende Krankheitsbilder nach dem Eindringen von Cakteenstacheln in die Haut der Finger. Wien. Klinische Wochenschrift 2: 1729.
  • Touton K (1932) Hauterkrankungen durch phanerogamische Pflanzen und ihre Produkte (Toxicodermia et Allergodermia phytogenes) [Skin Diseases Caused by Phanerogamic Plants and their Products (Toxicodermia et Allergodermia phytogenes)]. In: Jadassohn J (Ed.) Handbuch der Haut- und Geschlechtskrankheiten. Band IV, Teil I. Angeborene Anomalien. Lichtdermatosen. Pflanzengifte. Thermische Schädigungen. Einfluss Innerer Störungen auf die Haut [Handbook of Skin and Venereal Diseases. Volume IV, Part I. Congenital abnormalities. Photodermatoses. Plant toxins. Thermal injuries. Influence of internal disorders on the skin], pp. 487-697. Berlin: Julius Springer [doi] [WorldCat] [url] [url-2]
  • Warthin AS and Davies JE (1924) Cactus-spine pseudo-tubercules. Ann. Clin. Med. 2: 248.
  • Watt JM, Breyer-Brandwijk MG (1962) The Medicinal and Poisonous Plants of Southern and Eastern Africa. Being an account of their medicinal and other uses, chemical composition, pharmacological effects and toxicology in man and animal, 2nd edn. Edinburgh: E & S Livingstone [doi] [WorldCat] [url] [url-2]
  • Wheeler WM (1921) A new case of parabiosis and the "ant gardens" of British Guiana. Ecology 2: 89-103.
  • Whiting DA and Bristow JH (1975) Dermatitis and keratoconjunctivitis caused by a prickly pear (Opuntia microdasys). South African Medical Journal 49: 1445-1448.
  • Wimmer C (1926) Morphologisches über Pflanzen und Tiere, welche Hautschädigungen hervorrufen. [Morphology of plants and animals that cause skin damage]. In: Ullmann K, Oppenheim M, Rille JH (Eds) Die Schädigungen der Haut durch Beruf und gewerbliche Arbeit, Vol. 2, pp. 485-508. Leipzig: Leopold Voss [WorldCat] [url]
  • Winer LH and Zeilenga RH (1955) Cactus granulomas of the skin. Report of a case. AMA Archives of Dermatology 72: 566-569.



Richard J. Schmidt

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