Title: A Case of Anaphylaxis Following Topical Black Castor Oil Use.
Tolbert, Davina
Tolbert, Davina
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Title: A Case of Anaphylaxis Following Topical Black Castor Oil Use. Authors: Davina Tolbert, MPH; University of Vermont Robert Larner MD College of Medicine; Oben Ojong, DO; Larkin Community Hospital- Palm Springs Campus; Heather Woolery-Lloyd, MD University of Miami Miller School of Medicine Disclosures: The authors do not report any conflicts of interest at this time. Corresponding author: Davina Tolbert 612-910-0448 Davina.tolbert@med.uvm.edu Abstract Introduction Anaphylaxis is a severe, multisystem hypersensitivity reaction that can quickly escalate and result in death. In the United States the lifetime prevalence of anaphylaxis is 1.6% and increasing. Reports of allergic contact dermatitis and hair practices in African American women are increasing. A host of potential allergic contact dermatitis to Castor Oil, and a suspected case of anaphylaxis to a version of Castor Oil have been described. We present a case of anaphylaxis to topical application of Black Castor Oil (Ricin Communis). Case A 60-year-old African American female presented to the emergency department (ED) with an anaphylactic reaction to topical application of Black Castor Oil to her scalp. The patient experienced two previous pustular allergic contact dermatitis reactions after use of Black Castor oil on her scalp. The patient was treated after the second episode with Fluocinonide 0.05% topical lotion. After the third exposure, the patient experienced internal ear canal and tongue swelling; and dyspnea. Patient was taken to ED and treated with a total of three doses of IM Epinephrine, IV Solumedrol and IV Benadryl. After resolution of symptoms, patient was discharged with an oral prednisone taper and an EpiPen. Discussion Black castor oil contains Ricin, a toxic protein that can lead to atopy and anaphylactic reactions. Conclusion Little research on allergens in the beauty industry have focused on African American hair practices5. It is important that more African American hair practices be researched in order to inform and improve the medical management of these patients; especially when there exists a possibility for fatality.
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Medical Students
Medical Students
Date
2020-01-01