Abstract
Erythema multiformlike reaction is an infrequent manifestation of contact dermatitis caused by diverse allergens, such as exotic woods, topical medications, chemical compounds, and common allergens such as nickel and paraphenylenediamine. This is a report on a 59-year-old woman who developed an erythematous maculopapular symmetrical rash distributed mainly on the trunk, together with areas of perianal and gluteal eczema secondary to topical application of Thuja essential oil as confirmed by patch testing. Histopathologic findings in biopsy samples from erythema multiformlike reaction, the area of topical application of Thuja essential oil, and the patch test site were similar. To our knowledge, this is the first report of erythema multiformlike reaction caused by Thuja essential oil. The clinical and histopathologic variability of erythema multiformlike reaction, which can be characterized as an idiosyncratic pattern of response to the local or systemic absorption of several potent contact sensitizers, is discussed.
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