Acute bullous irritant contact dermatitis caused by a Pulsatilla koreana extract

Pulsatilla koreana is a plant that grows in Korea and China. A P. koreana extract (PKE) is made from the roots, leaves, and stems and has been used frequently in herbal medicine due to its anti-inflammatory effect. However, PKE can cause irritable contact dermatitis. A 52-year-old woman visited the hospital with painful blisters on both feet after PKE was applied the day before. She had plantar fasciitis on both feet for 4 months and had been told by her neighbors that PKE was a good treatment. Her feet were rinsed with saline to remove the toxin when she arrived at the hospital and were treated with antibacterial cream and an antihistamine. She recovered after 3 weeks with mild pigmentation on both feet.