Evidence for the etiologic role of ragweed pollen in the production of seasonal dermatitis has been well documented.1-4 Although possessing the common denominator of hypersensitivity, there are two distinct morphologic types of ragweed dermatitis, each dependent upon a different immunologic mechanism. One is typical atopic dermatitis associated with an immediate intracutaneous whealing response to the water-soluble pollen fraction, mediated through circulating serum reaginic antibody to ragweed. Here, the challenging exposure to wind-dispersed pollen grains occurs through the inhalant route. The second variety is allergic eczematous dermatitis of the contact type, mediated through a tissue-sensitizing factor and demonstrated by the delayed epidermal response to patch testing with the ether-acetone-soluble pollen fraction, "ragweed oil." This is further characterized by an inability to detect circulating serum antibody in the patient whose exposure to the oil-containing ragweed pollen, leaf, or stem is by direct cutaneous
COHEN SG. Seasonal Ragweed Dermatitis: Association of Immediate and Delayed Types of Pollen Sensitivity. AMA Arch Derm. 1959;79(3):328–333. doi:https://doi.org/10.1001/archderm.1959.01560150070010
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