Fingertip Dermatitis in a Retail Florist

Prevalence of plant contact dermatitis in retail florists varies with exposure, and the number of reports of contact allergy to cut tulips is rather small. Alpha-methylene-γ-butyrolactone is better known as the cause of both Alstroemeria dermatitis in retail florists and tulip finger in wholesale floral workers who handle the bulbs. Our patient presented with prominent erythema, scaling, and peeling of the skin of the thumb, index, and middle fingers of his right hand. Results of a patch test to alpha-methylene-γ-butyrolactone were strongly positive, and the patient determined that the exposure had occurred when he stripped leaves from the tulip stems to arrange cut flowers. Other natural sources of the antigen include Alstroemeria; Bomarea; Dioscorea hispida; Erythronium; Gagea; Fritillaria; and at least one species of onion, Allium triquetrum.