Ragweed dermatitis occurs in two principal forms:
Atopic ragweed dermatitis due to sensitivity to the protein fraction of ragweed.
Ragweed contact dermatitis, also called ragweed oil dermatitis, due to sensitivity to the oleoresin fraction of the plant.
It is important to distinguish between the two forms of ragweed dermatitis. Atopic ragweed dermatitis usually occurs as localized patches of a lichenified dermatitis during the ragweed season, namely, from the middle of August to October in the midwestern portion of the United States. The eyelids, sides of neck, and antecubital areas seem to be sites of predilection. Scratch and/or intradermal tests with protein extracts from ragweed pollens are positive. This type of pure atopic ragweed dermatitis is rare in my personal experience and usually seen in the adolescent or young adult.*
Ragweed contact dermatitis must be distinguished from it. Clinically it presents a diffuse, severely inflamed dermatitis of the exposed parts, especially the face and neck,
EPSTEIN S. Role of Dermal Sensitivity in Ragweed Contact Dermatitis. AMA Arch Derm. 1960;82(1):48–55. doi:10.1001/archderm.1960.01580010054008
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