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(Autumn Crocus family)
This family has recently been separated from the Liliaceae. It currently comprises about 165 species in 15 genera. The plants are geophytes growing from corms or tubers. They are found in Australia and from South Africa to western Europe and western Asia (Mabberley 1997).
Several are to be found in cultivation as ornamentals, particularly members of the genera Colchicum L., Gloriosa L., Littonia Hook., and Sandersonia Hook.
The Colchicaceae is characterised by the presence in the plants of greater or lesser amounts of colchicine (Vinnersten 2003), a nitrogen-containing substance that is often described erroneously as an alkaloid. Its biosynthetic precursor, demecolcine, is an alkaloid. Colchicum autumnale L., Colchicum luteum Baker, and Gloriosa superba L. are grown as sources of colchicine, which is used medicinally in the treatment of gout. Demecolcine (= colchamine) extracted from Colchicum corms has also been used medicinally, principally in the treatment of chronic myeloid leukaemia.
The dermatological significance of this plant family is almost entirely attributable to the presence in the plants of colchicine, demecolcine, and related substances. Although the concentrations of these substances do vary between the various cultivars, species and genera, all members of the family should be considered to be potentially irritating to the skin and eyes, and dangerously toxic on ingestion. Under suitably qualified medical supervision, isolates from these plants have use in the treatment of certain skin disorders including Behçet's syndrome, psoriasis, and various neoplastic and viral skin tumours.
- Colchicum L.
The 65 or so species of Colchicum are found in Europe, North Africa, Central Asia and Northern India (Mabberley 1997). Most of the species, and numerous cultivars derived therefrom are cultivated for the beauty of their crocus-like flowers.
- Colchicum autumnale L.
- Autumn Crocus, Meadow Saffron, Naked Ladies, Naked Boys
This species is the source of the crude drugs Colchici Cormus or Radix, Colchici Semen, and Colchici Flores, which were formerly official in many Pharmacopoeias. The usefulness of the plant in the treatment of gout has been recognised for several hundreds of years, as has its toxicity. Colchicum corm appeared in the London Pharmacopoeia from 1618 to 1639 and then was omitted until the 1788 edition (Trease & Evans 1966). Although the various crude drug preparations have now largely fallen out of use, colchicine extracted from this and other species of Colchicum remains in use in Western medicine. In addition to its use in the treatment of gout, colchicine is also used orally in the treatment of Behçet's syndrome (see, for example, Mizushima et al. 1977, Miyachi et al. 1981, and Wechsler 2002) and some forms of psoriasis (see, for example, Wahba & Cohen 1980, Zachariae et al. 1982, and Wong et al. 2001). Kaidbey et al. (1975) reported the successful use of topically-applied colchicine in the treatment of recalcitrant psoriasis. Colchicine has also been evaluated as a topical remedy for penile condylomata acuminata (von Krogh 1978, von Krogh 1981). These and other uses of colchicine in dermatologic therapy have been reviewed by Aram (1983) and by Bibas et al. (2005).
Orally administered colchicine may cause alopecia (Carr 1965), as may poisoning caused by ingestion of Colchicum autumnale (Gooneratne 1966). Alopecia is regarded as a late complication seen only in patients who recover from colchicine poisoning (Stapczynski et al. 1981, Milne & Meek 1998). Alopecia totalis in one patient (Thompson 1964) and a toxic epidermal necrolysis-like exanthem in another (Arroyo et al. 2004) have been reported following fatal suicidal overdoses of colchicine. Toxic epidermal necrolysis has also occurred in a patient who had taken colchicine and alcohol in desperation during an acute attack of gout (Lyell 1967).
Libermann et al. (1966) studied the skin-irritant activity of colchicine on mouse skin. Miyachi et al. (1981) investigated the effect of colchicine administered intraperitoneally on the degree of erythema and induration induced by 2,4-dinitrochlorobenzene (10% in acetone) when applied topically to the shaved skin of guinea pigs. Induration, but not erythema was reduced.
In experiments carried out on the eyes of white rabbits, Estable (1948) found that colchicine in dilute solutions (1:5000 – 1:500) elicited only mild reactions of short duration, but a strong solution (> 1:100) or the dry powder produced an inflammatory reaction.
In addition to colchicine, the corm contains demecolcine (= colchamine; = omain), an alkaloid that is best known as an orally-administered drug in the treatment of chronic myeloid leukaemia (Jelliffe & MacIver 1956, Todd 1967). Topically, demecolcine-containing ointment has been used in the treatment of superficial epitheliomatosis (Jackson 1958), condylomata acuminata (Bodanov & Ryzkova 1968), viral warts (Troshev et al. 1980), and other skin tumours (Cottini & Randazzo 1955, Iudkina 1965, Movsesian 1966, Vervel 1967, Vitkin 1969, Vitkin 1971), and has also been used as an adjunct to radiotherapy in the treatment of basal cell carcinoma (Asliaev et al. 1977, Bagecheva 1979).
Like colchicine, demecolcine is apt to cause alopecia (Jelliffe & MacIver 1956), and is irritant to the intact skin (Cottini & Randazzo 1955).
Touton (1932) was told about 2 cases of dermatitis in individuals who had been digging up the plants. A strongly erythematous reaction started on the hands, with erythema and oedema developing a little later on the face. The reaction was intensely pruritic. A number of other authors have subsequently noted that Colchicum autumnale leaves and/or corms are irritant to the skin, including Schwartz et al. (1947), Muenscher (1951), McCord (1962), Woods (1962), Behl et al. (1966), and North (1967), probably all ultimately from White (1887) who cited Stillé & Maisch (1884) where it is written that "Its topical action is shown by the redness, pricking, and diminished sensibility of the skin, produced by the application of the fresh cormus". Felter (1922) was more descriptive: "Upon the skin and mucosa colchicum is irritant, causing smarting and redness, sneezing and conjunctival hyperemia."
The ethnoveterinary use in Italy of Colchicum autumnale as an antiparasitic agent has been documented (Coassini Lokar & Poldini 1988, Viegi et al. 2003).
- Colchicum luteum Baker
- Indian Colchicum
This species is the source of the crude drugs Colchici Indici Cormus and Colchici Indici Flores, otherwise known as Indian colchicum. It is a source of colchicine, and is used in India and elsewhere as an alternative to Colchicum autumnale L. (see above).
- Gloriosa L.
The genus may comprise just one very variable species or perhaps 9 distinct species, which are natives of tropical Africa and tropical Asia (Mabberley 1997), but which are grown in glass houses elsewhere as they are highly decorative.
- Gloriosa superba L.
- Flame Lily, Glory Lily
In Indian traditional medicine, a paste of the root formed with water is used as an anodyne application in bites of poisonous insects, snake bites, scorpion stings, parasitic skin diseases, and leprosy (Nadkarni 1976). Biswas & Mukherjee (2003) and Katewa et al. (2004) note that a similar preparation is used in the treatment of "wounds". Mors et al. (2000) elaborated upon the reputation of Gloriosa superba as a snake-bite remedy, suggesting that the active consituents were the phytosterols β-sitosterol and stigmasterol together with the monomethyl ether of 2,6-dihydroxybenzoic acid.
According to Chopra & Badhwar (1940), the juice of the leaves is used to destroy lice in the hair.
The tubers, if eaten, cause numbness of the lips and tongue (Hardin and Arena 1974) which has been followed in one reported case by generalized alopecia (Gooneratne 1966).
The tubers yield colchicine (Clewer et al. 1915) and related alkaloids and are therefore dangerously toxic if ingested (see Colchicum autumnale L. above).
Frati et al. (1993) reported a case of occupational alopecia believed to have been caused by "lily bulbs" following accidental contact with the skin on the legs when the patient fell onto the bulbs whilst working in shorts. The authors of the report asserted that these bulbs (which were not identified botanically, but which might have been Gloriosa superba) contained "large quantities of colchicine". The patient developed an acute and widespread alopecia of the exposed limbs "after about a month" [?!], with subsequent regrowth of hair.
- Aram H (1983) Colchicine in dermatologic therapy. International Journal of Dermatology 22(10): 566-569
- Arroyo MP, Sanders S, Yee H, Schwartz D, Kamino H, Strober BE (2004) Toxic epidermal necrolysis-like reaction secondary to colchicine overdose. British Journal of Dermatology 150(3): 581-588
- Asliaev LA, Poluektov IA, Gatsula LN, Otyrko AG, Krugovov BA (1977) Povyshenie radiochuvstvitel'nosti raka kozhi kolkhaminovi maziu. [Increasing the radiosensitivity of skin cancer with colchamine ointment]. Meditsinskaia Radiologiia 22(6): 70
- Bagecheva MA (1979) Primenenie kolkhaminovoi mazi pri luchevom lechenii raka kozhi. [Use of colchamine ointment in the radiation therapy of skin cancer]. Meditsinskaia Radiologiia 24(5): 44-49
- Behl PN, Captain RM, Bedi BMS, Gupta S (1966) Skin-Irritant and Sensitizing Plants Found in India. New Delhi: PN Behl [WorldCat]
- Bibas R, Gaspar NK, Ramos-e-Silva M (2005) Colchicine for dermatologic diseases. Journal of Drugs in Dermatology 4(2): 196-204
- Biswas TK, Mukherjee B (2003) Plant medicines of Indian origin for wound healing activity: a review. International Journal of Lower Extremity Wounds 2(1): 25-39 [doi] [url] [pmid]
- Bodanov VA and Ryzkova GF (1968) Lechenie ostrokonechnykh kondilom omainom (kolkhaminom). [Treatment of condylomata acuminata with omain (colchamine)]. Vestnik Dermatologii i Venerologii 42(4): 87-88
- Carr AA (1965) Colchicine toxicity. Archives of Internal Medicine 115(1): 29-33
- Chopra RN, Badhwar RL (1940) Poisonous plants of India. Indian Journal of Agricultural Science 10(1): 1-44
- Clewer HWB, Green SJ, Tutin F (1915) The constituents of Gloriosa superba. Journal of the Chemical Society, Transactions 107(Pt I): 835-846
- Coassini Lokar L and Poldini L (1988) Herbal remedies in the traditional medicine of the Venezia Giulia Region (North East Italy). Journal of Ethnopharmacology 22(3): 231-279
- Cottini G-B, Randazzo S-D (1955) Emploi de la démécolcine en dermatologie. Premier travail: résultats cliniques. [Use of demecolcine in dermatology. First study: clinical results]. Dermatologica 110(6): 426-438 [doi] [url] [url-2] [pmid]
- Estable JJ (1948) The ocular effect of several irritant drugs applied directly to the conjunctiva. American Journal of Ophthalmology 31: 837-844
- Felter HW (1922) The Eclectic Materia Medica, Pharmacology and Therapeutics. Cincinnati, OH: John K Scudder [WorldCat] [url] [url-2]
- Frati C, Bevilacqua B, Battisti MG, Pizzutelli G (1993) Occupational alopecia in various workers after exposure to chemical agents. Acta Dermatovenerologica Alpina, Pannonica et Adriatica 2(4): 124-126
- Gooneratne BWM (1966) Massive generalized alopecia after poisoning by Gloriosa superba. British Medical Journal i(5494; Apr 23): 1023-1024 [doi] [url] [pmid]
- Hardin JW, Arena JM (1974) Human Poisoning from Native and Cultivated Plants, 2nd edn. Durham, NC: Duke University Press [WorldCat] [url]
- Iudkina LN (1965) Lechenie raka kozhi omainovoi maz'iu. [Treatment of skin cancer with omain ointment]. Vestnik Dermatologii i Venerologii 39(9): 44-48
- Jackson R (1958) Treatment of superficial epitheliomatosis with an ointment containing demecolcin. Canadian Medical Association Journal 78(12): 950-951
- Jelliffe AM and MacIver JE (1956) Desacetylmethylcolchicine in the treatment of myeloid leukaemia. British Journal of Cancer 10(4): 634-641
- Kaidbey KH, Petrozzi JW, Kligman AM (1975) Topical colchicine therapy for recalcitrant psoriasis. Archives of Dermatology 111(1): 33-36
- Katewa SS, Chaudhary BL, Jain A (2004) Folk herbal medicines from tribal area of Rajasthan, India. Journal of Ethnopharmacology 92(1): 41-46 [doi] [url] [pmid]
- Libermann C, Lazar P, Chouroulinkov I, Guerin M (1966) Action de la colchicine et de certaines substances voisines sur les glandes sébacées et sur l'épiderme de la peau de souris. [Action of colchicine and of certain closely related substances on the sebaceous glands and on the epidermis of the skin of mice]. Compte Rendu des Séances de la Société de Biologie et de ses Filiales 160(11): 1999-2003
- Lyell A (1967) A review of toxic epidermal necrolysis in Britain. British Journal of Dermatology 79(12): 662-671
- Mabberley DJ (1997) The Plant-Book. A portable dictionary of the vascular plants. 2nd edn. Cambridge: Cambridge University Press
- McCord CP (1962) The occupational toxicity of cultivated flowers. Industrial Medicine and Surgery 31(8): 365-368
- Milne ST, Meek PD (1998) Fatal colchicine overdose: report of a case and review of the literature. American Journal of Emergency Medicine 16(6): 603-608 [doi] [url] [pmid]
- Miyachi Y, Takigawa M, Imamura S (1981) Suppression of DNCB-induced irritant dermatitis by colchicine. Acta Dermato-Venereologica 61(4): 307-311
- Miyachi Y, Taniguchi S, Ozaki M, Horio T (1981) Colchicine in the treatment of the cutaneous manifestations of Behçet's disease. British Journal of Dermatology 104(1): 67-69
- Mizushima Y, Matsumura N, Mori M, Shimizu T, Fukushima B, Mimura Y, Saito K, Sugiura S (1977) Colchicine in Behçet's disease. Lancet 310(8046): 1037
- Mors WB, do Nascimento MC, Ruppelt Pereira BM, Alvares Pereira N (2000) Plant natural products active against snake bite — the molecular approach. Phytochemistry 55(6): 627-642
- Movsesian AK (1966) Otdalennye rezul'taty lecheniia raka kozhi omainom. [Long-term results of the treatment of skin cancer with omain]. Voprosy Onkologii 12(9): 8-12
- Muenscher WCL (1951) Poisonous Plants of the United States, 2nd edn. New York: Macmillan Company [WorldCat]
- Nadkarni AK (1976) Dr. K. M. Nadkarni's Indian Materia Medica. With ayurvedic, unani-tibbi, siddha, allopathic, homeopathic, naturopathic & home remedies, appendices & indexes, Revised enlarged and reprinted 3rd edn, Vols 1 & 2. Bombay: Popular Prakashan [WorldCat] [url]
- North PM (1967) Poisonous Plants and Fungi in Colour. London: Blandford Press
- Schwartz L, Tulipan L, Peck SM (1947) Occupational Diseases of the Skin. 2nd edn. London: Henry Kimpton
- Stapczynski JS, Rothstein RJ, Gaye WA, Niemann JT (1981) Colchicine overdose: report of two cases and review of the literature. Annals of Emergency Medicine 10(7): 364-369
- Stillé A and Maisch JM (1884) The National Dispensatory : containing Natural History, Chemistry, Pharmacy, Actions, and Uses of Medicines including those recognized in the Pharmacopœias of the United States, Great Britain and Germany, with Numerous References to the French Codex. 3rd edn. London: J & A Churchill
- Thompson GW (1964) Alopecia totalis. Following suicidal colchicine overdose. Journal of the Royal Army Medical Corps 110: 113-116
- Todd RG (Ed.) (1967) Martindale. The Extra Pharmacopoeia. 25th edn. London: Pharmaceutical Press [WorldCat]
- Touton K (1932) Hauterkrankungen durch phanerogamische Pflanzen und ihre Produkte (Toxicodermia et Allergodermia phytogenes) [Skin Diseases Caused by Phanerogamic Plants and their Products (Toxicodermia et Allergodermia phytogenes)]. In: Jadassohn J (Ed.) Handbuch der Haut- und Geschlechtskrankheiten. Band IV, Teil I. Angeborene Anomalien. Lichtdermatosen. Pflanzengifte. Thermische Schädigungen. Einfluss Innerer Störungen auf die Haut [Handbook of Skin and Venereal Diseases. Volume IV, Part I. Congenital abnormalities. Photodermatoses. Plant toxins. Thermal injuries. Influence of internal disorders on the skin], pp. 487-697. Berlin: Julius Springer [doi] [WorldCat] [url] [url-2]
- Trease GE, Evans WC (1966) A Textbook of Pharmacognosy, 9th edn. London: Baillière, Tindall and Cassell [WorldCat]
- Troshev K, Venkova V, Ivanova A, Diankova L (1980) Metod lecheniia borodavok kozhi virusnoi etiologii s primeneniem 0,5% kolkhaminovoi mazi. [Method of treatment of skin warts of viral etiology with 0,5% colchamine ointment]. Vestnik Dermatologii i Venerologii (4): 51-52
- Vervel EM (1967) Protivoopukholevye svoitva kolkhamina (omaina). [Antitumor properties of colchamine (omain)]. Voprosy Onkologii 13(3): 101-112
- Viegi L, Pieroni A, Guarrera PM, Vangelisti R (2003) A review of plants used in folk veterinary medicine in Italy as basis for a databank. Journal of Ethnopharmacology 89(2-3): 221-244 [doi] [url] [pmid]
- Vinnersten A (2003) Tracing History: Phylogenetic, Taxonomic, and Biogeographic Research in the Colchicum Family. Uppsala: Acta Universitatis Upsaliensis
- Vitkin BS (1969) Lechenie mnozhestvennogo raka kozhi kolkhaminom. [Treatment of multiple skin cancer with colchamine]. Voprosy Onkologii 15(9): 19-22
- Vitkin BS (1971) O lechenii raka rakoviny kolkhamimom v vysokoi kontsentratsii. [Treatment of cancer of the auricular conchae with colchamine in high concentrations]. Voprosy Onkologii 17(8): 101-103
- von Krogh G (1978) Topical treatment of penile condylomata acuminata with podophyllin, podophyllotoxin and colchicine. A comparative study. Acta Dermato-Venereologica 58(2): 163-168
- von Krogh G (1981) Podophyllotoxin for condylomata acuminata eradication. Clinical and experimental comparative studies on Podophyllum lignans, colchicine and 5-fluorouracil. Acta Dermato-Venereologica 98(Suppl): 1-48
- Wahba A and Cohen H (1980) Therapeutic trials with oral colchicine in psoriasis. Acta Dermato-Venereologica 60(6): 515-520
- Wechsler B (2002) Colchicine et maladie de Behçet: une efficacité enfin reconnue! [Colchicine and Behçet's disease: an efficacious treatment finally recognized!]. Revue de Médecine Interne 23(4): 355-356
- White JC (1887) Dermatitis Venenata: an account of the action of external irritants upon the skin. Boston: Cupples and Hurd [doi] [WorldCat] [url] [url-2]
- Wong SS, Tan KC, Goh CL (2001) Long-term colchicine for recalcitrant palmoplantar pustulosis: treatment outcome in 3 patients. Cutis 68(3): 216-218
- Woods B (1962) Irritant plants. Transactions of the St John's Hospital Dermatological Society 48: 75-82 [doi] [url] [url-2] [pmid]
- Zachariae H, Kragballe K, Herlin T (1982) Colchicine in generalized pustular psoriasis: clinical response and antibody-dependent cytotoxicity by monocytes and neutrophils. Archives for Dermatological Research 274(3-4): 327-333