Botanical Dermatology

ALLERGIC CONTACT DERMATITIS

ANACARDIACEAE AND RELATED FAMILIES

The family Anacardiaceae (the cashew family) includes the genus Toxicodendron (poison ivy, poison oak, poison sumac, etc.) and other genera with cross-reactive allergenic plants (Mangifera, Anacardium, Semecarpus, and Gluta). The Poison Ivy group of plants was initially placed in the very large genus Rhus by Linnaeus. However, the name Toxicodendron ('Poison tree') was colloquially used for poison ivy for millennia. There are many good reasons to separate Rhus from Toxicodendron. Not only are members of Rhus not allergenic, they also possess very different field identification features from Toxicodendrons.66 Since three classic treatises successfully argued for the placement of poison ivy, poison oak, and poison sumac in the genus Toxicodendron in 1937,67 1963,10 and in 1971,11 a major shift toward the use of Toxicodendron has occurred in scientific publications.66, 68, 69 However, this acceptance has not occurred in the dermatology literature, and reasons for this are obscure. Table 9: Important members of the Anacardiaceae and allergenically-related families. Poison Ivy (Common or Eastern) Poison Ivy (Norhtern or Western) Poison Ivy (African) Poison Oak (Eastern) Poison Oak (Western) Poison Sumac Cashew Mango Indian Marking Nut Japanese Lacquer Tree Rengas Tree Toxicodendron radicans Toxicodendron rydbergii Smodingium argutum Toxicodendron toxicarium Toxicodendron diversilobum Toxicodendron vernix Anacardium occidentale Mangifera indica Semecarpus anacardium Toxicodendron verniciflua Gluta spp.

(Allergenically but not botanically related) Ginkgo Spider Flower, Silk Oak Ginkgo biloba (Ginkgoaceae) Grevillea spp. (Proteaceae)

Identification of toxicodendrons 66 One of the best articles in the dermatology literature teaching the identification of these notorious plants was published in 1986 by Guin and Beaman.66 These authors point out that their article serves as the basis for the successful identification of these plants, but that to become truly proficient, one must identify and observe several plants in a location where they can be observed throughout the year. As noted in the list of Anacardiaceae above, there are two species each of poison ivy and poison oak and one species of poison sumac listed that are common to the United States. Some of these have multiple subspecies. Poison oak and poison ivy are weeds that grow along roads, trails, or streams; they possess three leaflets (sometimes five) per leaf (compound leaves). Poison sumac contains 7-13 leaflets per leaf. Young leaves are frequently red in color, and the mature fruit (drupes) are tan or cream colored and have no hairs. Many botanists say that poison ivy and poison oak are so closely related that they cannot reliably distinguish these plants in the field. Classically, poison ivy leaves have pointed tips and are ovate (widest point below the center). Poison oak leaves usually have rounded ends. Western poison oak has oval leaves, while Eastern poison oak has variable leaf appearances that can mimic white oak leaves. Toxicodendron leaves have three or more leaflets (ternate). (The old saying about Poison Ivy "Leaves of three; leave them be" refers to each leaf having three leaflets.) Flowers and fruit (which do not grow until a plant is at least three years old) arise in an axillary position, that is, in the angle between the leaf and the twig from which the leaf is borne.