An Unexpected Reaction to Topical Garlic Medicament - A Case Report of Irritant Contact Dermatitis Successfully Managed in Primary Care

Irritant contact dermatitis (ICD) is a common skin condition in primary care. The frequent cause of ICD includes hair dye, nail polish, paints, cleaners, soap, and detergent. We present a case of ICD caused by topical garlic medicament, successfully identified and managed in primary care. A 20-year-old woman presented with a sudden onset of multiple painful localized blisters on the right antecubital fossa. She reported applying raw garlic paste to the area one day before the clinic visit to treat mild itchiness. She had no known allergies or medical illnesses. Otherwise, there were no rashes elsewhere or oral and genital ulcers. She was not on any regular medication or taking traditional medication. Examination revealed multiple bullae on the antecubital fossa with perilesional erythema. The lesion was sharply bordered within the contact areas, was asymmetric, and did not spread elsewhere. The clinical history of immediate bullae formation after direct contact with garlic was consistent with ICD due to garlic medicament. The lesions were managed with regular dressings. At one week follow-up, the lesions had healed well. She was advised to avoid further application of topical garlic medicines. Although Allium sativum (garlic) has been used either topical or orally as a medicinal treatment worldwide for thousands of years to treat various conditions, it still has the potential to cause irritant dermatitis when applied to skin and mucosa. Patients and healthcare providers should be cautious of the potential side effects, such as ICD, when using garlic for medicinal purposes.