Contact dermatitis due to hardy Primula species and their cultivars.

For more than 100 years, it has been widely held that of all the Primula species to cause allergic contact dermatitis, P. obconica is the most likely culprit, particularly in Northern Europe. The main sensitizer is primin, but other sensitizers are reported. Other species are rarely implicated, but we suspect from our discussions with Primula growers that this is probably a consequence of under-reporting. Moreover, cutaneous reactions to other hardy Primula species and cultivars would appear to be milder and may sometimes be associated with a state of tolerance after repeated handling. With the co-operation of members of the Midland and West Section of the National Auricula and Primula Society of the UK, 462 questionnaires were sent out to members and 316 replies were returned (response rate 68.4%) with data on 320 growers. 84 out of a total of 320 (26.25%) attributed a cutaneous reaction to Primula species, whereas 236 (73.75%) reported no reaction. Of the 84 who reported reactions, 48 suspected P. auricula, 34 P. obconica, 10 P. vulgaris, 5 P. allionii, 3 P. marginata and 2 P. forrestii 19 believed that they had reacted to 2 or more species of Primula. Our study suggests that Primula species other than P. obconica may elicit dermatitis more frequently than previously recorded.

Acute dysarthria induced by low dose methotrexate therapy in a patient with erythrodermic cutaneous T-cell lymphoma: an unusual manifestation of neurotoxicity.

Neurotoxicity has been associated on rare occasions with methotrexate therapy. We now report the case of a 71-year-old man with erythrodermic cutaneous T-cell lymphoma who developed symptoms of dysarthria and inco-ordination within 1 month of the initiation of oral methotrexate; discontinuation of the therapy then resulted in a gradual resolution of the problems.