ALSTROEMERIACEAE

(Alstroemer family)

• Medicinal / Folk-medicinal aspects:  •
• Adverse effects: Tuliposide A, the biosynthetic precursor of the allergenic lactone tulipalin A, has been detected in many species of Alstroemeria and Bomarea Mirb. Gardeners, florists, and housewives are therefore at risk. •
• Veterinary aspects: •

Whilst Mabberley (1987) does not recognise this as a distinct family but as a subdivision of the Liliaceae, both Willis (1973) and Brummitt (1992) regard the Alstroemeriaceae as a distinct family of 4 genera and about 150 species. The plants are natives of Central and South America. Certain species of Alstroemeria L., notably A. aurantiaca D.Don and A. ligtu L., are often cultivated in gardens and are becoming increasingly popular in the cut flower trade.

Alstroemeria L.

Peruvian Lily, St Martin's Flower

The allergenic potential of all members of this genus has been stressed by Slob et al. (1975). Tuliposide A, from which the allergenic lactone tulipalin A is produced by enzymatic hydrolysis following damage to the plant, has been detected in the following species:

Alstroemeria aurea Graham

[syn. Alstroemeria aurantiaca D.Don]

Alstroemeria hookeri Sweet

[syn. Alstroemeria hookeriana Schult. & Schult.f.]

Alstroemeria inodora Herb.

Alstroemeria ligtu L. subsp. ligtu

[syn. Alstroemeria haemantha Ruiz & Pav.]

Alstroemeria magnifica subsp. gayana (Phil.) Ehr.Bayer

[syn. Alstroemeria gayana Phil.]

Alstroemeria paupercula Phil.

[syn. Alstroemeria violacea Phil.]

Alstroemeria pelegrina L.

Alstroemeria philippii Baker

Alstroemeria psittacina Lehm.

Alstroemeria pulchra Sims

Alstroemeria revoluta Ruiz & Pav.

Alstroemeria versicolor Ruiz & Pav. 

Generally, tuliposide A was found to be present in large quantities (0.2–2% w/w fresh plant) in all parts of the plants (Slob et al. 1975).

Bomarea carderi Mast.

Bomarea edulis (Tussac) Herb.

[syn. Alstroemeria edulis Tussac]

Chile Arrowroot

The leaves, stems, and flowers of both species have been found to contain small quantities (up to 0.2% w/w fresh plant) of tuliposide A from which the allergenic lactone tulipalin A may be produced if the plant material is damaged (Slob et al. 1975).

DERMATOLOGY

Tuliposide A has been shown to evoke dermatitis in sensitised individuals (Verspyck Mijnssen 1969). It is probable that the effect resulted from formation of tulipalin A, which is allergenic (Brongersma-Oosterhof 1967, Verspyck Mijnssen 1969), on the skin following in situ hydrolysis of tuliposide A (Beijersbergen 1972).

Contact dermatitis is caused by recently damaged plants and bulbs, and gives rise to a condition known as tulip fingers (Hjorth & Wilkinson 1968, Verspyck Mijnssen 1969).

The first case reports of allergic contact dermatitis produced by Alstroemeria species appeared early in the 1970s (Rook 1970a, Cronin 1972), subsequently appearing with increasing regularity (Mitchell 1974, van Ketel et al. 1975, Hoffman 1980, Rook 1981, Rycroft & Calnan 1981, Björkner 1982, Hausen & Schubert 1983, Hausen et al. 1983). The reasons for the sudden appearance and increasing incidence were discussed by Rook (1981), who described the changes in use of the plants since about 1970.

Typically, patients are florists who present with hyperkeratosis, fissuring, erythema, and tenderness of the tips of all digits on both hands (Rook 1981). Oncholysis may also occur, this condition having been observed in a patient also suffering from psoriasis (Rycroft & Calnan 1981). The clinical pattern is identical with that produced (on the left hand in a right-handed cook) by the garlic clove (Allium sativum L., fam. Amaryllidaceae), but is bilaterally symmetrical. This pattern is associated with the current popularity of alstroemerias as a component of floral bouquets. Earlier cases presented with a less distinct pattern of dermatitis of the hands and forearms, this being associated with the use of alstroemerias as a cut flower (Rook 1981). More unusually, depigmentation may be observed on resolution of the eczema (Björkner 1982).

Patients are also, typically, sensitive to Tulipa L. species (fam. Liliaceae), as might be expected on consideration of the comparative phytochemistry of the two genera. However, Rycroft & Calnan (1981) described a case in which the patient did not react to "tulip". Details of the method of preparation of the plant material for patch testing were not given, but the possibility of a false negative reaction was considered.

References

• Beijersbergen JCM (1972) A method for determination of tulipalin A and B concentrations in crude extracts of tulip tissues. Recueil des Travaux Chimiques des Pays-Bas : Journal of the Royal Netherlands Chemical Society 91(10): 1193-1200 [doi] [url] [url-2]
• Björkner BE (1982) Contact allergy and depigmentation from alstroemeria. Contact Dermatitis 8(3): 178-184 [doi] [url] [url-2] [pmid]
• Brongersma-Oosterhoff UW (1967) Structure determination of the allergenic agent, isolated from tulip bulbs. Recueil des Travaux Chimiques des Pays-Bas : Journal of the Royal Netherlands Chemical Society 86(7): 705-708 [doi] [url] [url-2]
• Brummitt RK (1992) Vascular Plant Families and Genera. Kew: Royal Botanic Gardens [WorldCat]
• Cronin E (1972) Sensitivity to tulip and alstroemeria. Contact Dermatitis Newsletter (11): 286 [url]
• Hausen BM, Schubert H (1983) Sensitization and occurrence of tuliposides in Alstroemeria hybrids (Alstroemeriaceae). Allergologie 6(2): 60
• Hausen BM, Prater E, Schubert H (1983) The sensitizing capacity of Alstroemeria cultivars in man and guinea pig. Remarks on the occurrence, quantity and irritant and sensitizing potency of their constituents tuliposide A and tulipalin A (α-methylene-γ-butyrolactone). Contact Dermatitis 9(1): 46-54 [doi] [url] [url-2] [pmid]
• Hjorth N, Wilkinson DS (1968) Contact dermatitis IV. Tulip fingers, hyacinth itch and lily rash. British Journal of Dermatology 80(10): 696-698 [doi] [url] [url-2] [pmid]
• Hoffmann H, Schulsinger C, Hamann K (1981) Alstroemeria-eksem. Et nyt erhverveksem i Danmark. [Alstroemeria dermatitis. A new occupational dermatitis in Denmark]. Ugeskrift for Læger 143(12): 754 [pmid]
• Mabberley DJ (1987) The Plant-Book. A portable dictionary of the higher plants. Cambridge: Cambridge University Press
• Mitchell JC (1974) Applied chemotaxonomy of plants I. A biological model. Contact Dermatitis Newsletter (16): 494-500 [url]
• Rook A (1970) Alstroemeria causing Contact Dermatitis in a florist also allergic to Tulips. Contact Dermatitis Newsletter (7): 166 [url]
• Rook A (1981) Dermatitis from Alstroemeria: Altered clinical pattern and probable increasing incidence. Contact Dermatitis 7(6): 355-356 [doi] [url] [url-2] [pmid]
• Rycroft RJG, Calnan CD (1981) Alstroemeria dermatitis. Contact Dermatitis 7(5): 284 [doi] [url] [url-2] [pmid]
• Slob A, Jekel B, de Jong B, Schlatmann E (1975) On the occurrence of tuliposides in the Liliiflorae. Phytochemistry 14(9): 1997-2005 [doi] [url]
• van Ketel WG, Verspyck Mijnssen GAW, Neering H (1975) Contact eczema from alstroemeria. Contact Dermatitis 1(5): 323-324 [doi] [url] [url-2] [pmid]
• Verspyck Mijnssen GAW (1969) Pathogenesis and causative agent of "tulip finger". British Journal of Dermatology 81(10): 737-745 [doi] [url] [url-2] [pmid]
• Willis JC (1973) A Dictionary of the Flowering Plants and Ferns, 8th edn. (Revised by Airy Shaw HK). Cambridge: Cambridge University Press [WorldCat] [url]

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