Phytocontact dermatitis due to Ranunculus arvensis mimicking burn injury: report of three cases and literature review

Burn injuries can be encountered in all ages. The most common burn injuries among the Turkish population are caused by a variety of causes: fires, scalding substances (i.e., traditional Turkish tea, hot milk, etc.), electricity and chemical agents. When taking into account the mechanisms of chemical burns, it was observed that 4% of cases were caused by the application of herbs used as traditional medication [1]. Despite the advances in medicine, a tendency towards using alternative treatments can be seen in every population, including the Turkish one, and plant application is among the most common methods used in folk medicine.Ranunculus arvensis (a member of the Ranunculaceae family) is a wild plant traditionally used in the Far East to treat arthritis, asthma, gout, high fever and psoriasis, and is highly allergenic in spring during the flowering period. In Turkey, the plant is frequently seen in the high mountains of the Mediterranean region and the southeastern and eastern regions of Anatolia, which are agricultural areas with plant production [2-11]. Herein, we present three patients with chemical burns caused by Ranunculus arvensis used as poultice around the knees and the thumb for the treatment of rheumatic symptoms.A 48-year-old man was admitted to our emergency department because of an open wound on his right thumb (Figure 1). Following a neighbor's advice, the patient had applied bruised plant material as a poultice to his right thumb, covering it with an occlusive bandage for 1 h to treat arthralgia. This procedure had resulted in pain and bullous and erythematous lesions on the treated area. The patient did not apply any other substance to the wound and left it open. One day later, as there was no improvement, the patient presented to our clinic and was hospitalized. The lesion healed within 3 weeks with appropriate topical fusidic acid therapy and daily dressing changes. The plant specimens provided by the patient were identified in the Department of