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.
CONCLUSION
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.
DISCLOSURES
The authors have no conflicts of interest to declare.
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- 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, GarcÃa-DÃez A. Occupational allergic contact dermatitis from eugenol, oil of cinnamon and oil of cloves in a physiotherapist. Contact Dermatitis. 1999;41(6):346-347.
AUTHOR CORRESPONDENCE
Nikoo Cheraghi MDnikoo.c@gmail.com