Perioral Contact Dermatitis Caused by Limonene Hydroperoxide in Cannabis Vaping Products

Main Article Content

Kevin Mai
Quang D. Pham
Joseph Haquang
Diem Q. Pham DO

Keywords

Limonene, Limonene Hydroperoxide, Cannabis, Marijuana, Allergic Contact Dermatitis, Vaping

Abstract

Limonene is a fragrant terpene commonly found in household and cosmetic products due to its fresh aroma. When exposed to air, limonene autoxidizes to form limonene hydroperoxide, a potent allergen that can cause allergic contact dermatitis. Recently, as the popularity and availability of limonene increased, it has been incorporated into novel products such as flavoring agents for electronic cigarettes or vapes. With the rising acceptance and popularity of marijuana, this usage has extended to cannabis vaping products. Here, we report an unusual presentation of an allergic contact dermatitis reaction to limonene hydroperoxide stemming from cannabis vaping products.

References

1. Anandakumar P, Kamaraj S, Vanitha MK. D-limonene: A multifunctional compound with potent therapeutic effects. J Food Biochem. Jan 2021;45(1):e13566. doi:10.1111/jfbc.13566

2. Christensson JB, Johansson S, Hagvall L, Jonsson C, Borje A, Karlberg AT. Limonene hydroperoxide analogues differ in allergenic activity. Contact Dermatitis. Dec 2008;59(6):344-52. doi:10.1111/j.1600-0536.2008.01442.x

3. de Groot A. Limonene Hydroperoxides. Dermatitis. Nov/Dec 2019;30(6):331-335. doi:10.1097/DER.0000000000000465

4. Bitzer ZT, Goel R, Reilly SM, et al. Effect of flavoring chemicals on free radical formation in electronic cigarette aerosols. Free Radic Biol Med. May 20 2018;120:72-79. doi:10.1016/j.freeradbiomed.2018.03.020

5. Pesonen M, Suomela S, Kuuliala O, Henriks-Eckerman ML, Aalto-Korte K. Occupational contact dermatitis caused by D-limonene. Contact Dermatitis. Nov 2014;71(5):273-9. doi:10.1111/cod.12287

6. Mowad CM, Anderson B, Scheinman P, Pootongkam S, Nedorost S, Brod B. Allergic contact dermatitis: Patient diagnosis and evaluation. J Am Acad Dermatol. Jun 2016;74(6):1029-40. doi:10.1016/j.jaad.2015.02.1139

7. Peiser M, Tralau T, Heidler J, et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci. Mar 2012;69(5):763-81. doi:10.1007/s00018-011-0846-8

8. Dittmar D, Schuttelaar MLA. Contact sensitization to hydroperoxides of limonene and linalool: Results of consecutive patch testing and clinical relevance. Contact Dermatitis. Feb 2019;80(2):101-109. doi:10.1111/cod.13137

9. Federico JR, Basehore BM, Zito PM. Angular Chelitis. StatPearls. 2022.

10. Cappelli L, Poiset S, Greenberger B, Bar-Ad V. Thermoplastic Mask-Induced Contact Dermatitis: A Case Report. Cureus. Apr 2022;14(4):e23815. doi:10.7759/cureus.23815

11. Jones K, Salzman GA. The Vaping Epidemic in Adolescents. Mo Med. Jan-Feb 2020;117(1):56-58.