Resident Rounds: Part III - Case Report: Betel Quid Induced Irritant Contact Dermatitis of the Hand
June 2016 | Volume 15 | Issue 6 | Features | 789 | Copyright © June 2016
Regine J. Mathieu BS,a Nikoo Cheraghi MD,b and Marian A. Russo MDb
aNew York Medical College, School of Medicine, Valhalla, NY
bNew York Medical College, Department of Dermatology, New York, NY
been previously reported.8 Eugenol, the major component of
betel leaf containing psychoactive ingredients, has also been
reported to cause allergic contact dermatitis.2,10 In our patient,
although patch testing was not performed, the clinical appearance
and distribution of the rash indicates a contact dermatitis
to a component of the betel quid, likely due to the irritating
alkaline slaked lime.
The practice of chewing betel nut mixed with slaked lime paste,
tobacco, and betel leaf is not common in the United States;
however, when faced with a patient with a non-correlating
history and physical exam, inquiry into cultural practices is imperative
for accurate diagnosis.
The authors have no conflicts of interest to declare.
- Raghavan V, Baruah HK. Arecanut: India’s popular masticatory—history,
chemistry and utilization. Econ Bot.1958;12(4):315-345.
- Nelson BS, Heischober B. Betel nut: a common drug used by naturalized
citizens from India, Far East Asia, and the South Pacific Islands. Ann Emerg
- Mankapure PK, Humbe JG, Mandale MS, Bhavthankar JD. Clinical profile of
108 cases of oral lichen planus. J Oral Sci. 2016;58(1):43-47.
- Bhat SJ, Blank MD, Balster RL, Nichter M, Nichter M. Areca nut dependence
among chewers in a South Indian community who do not also use tobacco.
- Tsai YS, Lee KW, Huang JL, et al. Arecoline, a major alkaloid of areca nut,
inhibits p53, represses DNA repair, and triggers DNA damage response in
human epithelial cells. Toxicology. 2008;249(2-3):230-237.
- Singh G. Betel chewers’ perleche. Br J Dermatol. 1973;89(1):98.
- Sharan RN, Mehrotra R, Choudhury Y, Asotra K. Association of betel
nut with carcinogenesis: revisit with a clinical perspective. PLoS One.
- Wang BJ, Guo YL, Guo HR, Chang HY. Piper betle L. inflorescence causes
allergic contact dermatitis of the hands during betel quid assembly. Contact
- Blank M, Deshpande L, Balster RL. Availability and characteristics of betel
products in the U.S. J Psychoactive Drugs. 2008;40(3):309-313.
- Sánchez-Pérez J, García-Díez A. Occupational allergic contact dermatitis
from eugenol, oil of cinnamon and oil of cloves in a physiotherapist. Contact
Nikoo Cheraghi MDnikoo.email@example.com