Sabra dermatitis

I'm struggling. Does anyone know who treats this? Is there any doctor out there who treats this please?!?!?!

I have the exact problem after hiking on a remote cattle ranch in NM!
It's been 6 years, and I've seen at least 6 dermatologist's. 2 Rheumatologist's due to severe joint swelling & pain.
I have brought research papers on prickly pear glochids, that describe my symptoms exactly. For six weeks I hiked this rural, cactus infested ranch. I picked Prickly Pears with leather gloves, and could never wear them again, due to the glochids penetrating the leather, and never came out. I had glochids embedded everywhere, with no information available to help. My skin is scarred, and granulomas have formed filled with these spines.
I was labeled a picker, like the other gentleman, and turned away, repeatedly, with absolutely no relief.
I have several environmental allergies, and the embedded glochids cause my skin to erupt. My health deteriorated rapidly over the years. I called Mayo Clinic 3 times and begged them to help me. I was turned away.
Drs need to listen to what happened to the patient. From the beginning, I told them, I was exposed to them for 6 weeks, and would try to scub them out everynight with a buff puff.
I now know that was the worst thing I could have done. Someone please help me find a Dr will listen, and help me. I have become a recluse, and want someone to listen & help!

Welcome @bridgettekh and @marcy154, I'm sorry that you both are having difficulty finding a doctor that treats sabra dermatitis. I'm not sure if you have tried contacting a teaching hospital but it might be a good place to start looking for a dermatologist or specialist that has some experience with the condition. Here's a list of U.S. Teaching Hospitals - https://healthguideusa.org/teaching_hospitals.htm.

One of the doctor researchers for the following 2020 research on sabra dermatitis has an email address on the paper and might be able to offer some doctor suggestions by contacting her.
-- Sabra dermatitis: combined features of delayed hypersensitivity and foreign body reaction to implanted
glochidia: https://escholarship.org/content/qt2157f9g0/qt2157f9g0_noSplash_ce5d0d33607b76ef99e9dcd44464be77.pdf

@marcy154, You mentioned you tried calling Mayo Clinic 3 times and were turned away. Mayo Clinic has more requests for appointments than available openings in some departments. It might be worth trying to get a referral from your primary care doctor. Another option might be a Mayo Clinic Care Network member where there doctors are able to access all of Mayo's resources and collaborate with specialists at other locations. Here's more information - https://www.mayoclinic.org/about-mayo-clinic/care-network/network-members.

Good evening, My name is Jessica. I am currently having the same problem, I touched my cactus by accident while pulling weeds in Feb 2023. I must have touched the back of my neck. I have had a non healing wound since then. Although it currently feels better now,I am still dealing with it. I also have this weird stingy material almost like dried grass continue to expel itself. I have been to many doctors and of courses they all dismiss me. I also recently had surgery for a macula hole in my eye and I am almost conceived it was caused by the chronic inflammation in my neck for the last two 2.5 years. I am so at the end of my rope behind this and no one taking me serious.

I am also struggling too.

Same everyone, I finally found a dermatologist who I explained the other's referring to me having a mental disorder after my severe Sabra Dermititis..that being said..she was able to detect Prugularuis nodularis in my skin now, 2+. years later with weird skin eruptiontionstions continuing after thousands of glochoids removed..burns, itches, bubbles up like blisters if you itch it ..and becomes more itchy.. VERY similar to what it felt like to have glochoids in you. My skin comes of in hard sharp like flakes, black, brown and red little scabs form all over over the bumps as well, that bleed easily.

Sometimes these breakouts occur in areas I never had glochoids and really bad in the areas where they were dense in my skin and a lot of excursion occurred.

So heads up. Not a typical presentation if PN...no large nodules...not necessarily areas that I "itched," a lot nessissarily, ..

I am also have existing immune system issues..I am following a protocol now for management of PN, am feeling a lot better.

I was very depressed about being misdiagnosed to begin with. Sabra Dermatitis is unbelievable challenging. Best advice also was I removed all my Prickly PeR cactus and professionally clean or deep clean your hope. Keep NoBedding, clothing or shoes that may have glochoids!!! I repoked myself a lot that way!!

Best of luck!!! Hope this helps someone!

Hi can you suggest me some expert doctors in this.
I live in Milan Italy and wondering where i can have a good treatment fo this.
Thanks

I have seen 19 dermatologists trained at several major medical schools, including five from Yale, four from Brown, one from Harvard, three from the University of Miami, one from Mount Sinai, and others. I even attended Yale dermatology Grand Rounds in New Haven and consulted with the head of Brown’s Dermatology Department.
Over the course of these evaluations, I have been prescribed treatments including Risperdal, which is typically used for schizophrenia, and Dupixent for prurigo nodularis. The experience has been so extensive that I could write a book about it. Below is AI generated:
"Information from Google AI Gemini:
It is exhausting to move from one specialist to another, especially when providers seem unfamiliar with what you are experiencing.
What you are describing—cactus plant material remaining in the skin and causing spreading, persistent, or traveling lesions over many years—is consistent with what medical literature describes as a chronic foreign-body granulomatous reaction. In some cases, this can behave like a slow-moving inflammatory track beneath the skin.
Standard dermatology visits often focus on more common surface-level skin conditions, so deep or migrating organic material may not be recognized. The key questions are why this can happen, what approaches literature supports, and which specialists are best equipped to evaluate it.
Why Standard Evaluations May Miss the Problem
Organic plant material, such as cactus spines or glochids, behaves differently from inert materials like glass or metal.
• Limited visibility on basic imaging: Cactus material is often radiolucent, meaning it may not appear on a standard X-ray. If a clinician relies only on visual inspection or basic imaging, the material may be missed.
• Barbed tracking effect: Some cactus spines, especially glochids or cholla fragments, have microscopic backward-facing barbs. Normal movement of the skin, muscle, and connective tissue may push fragments deeper or sideways over time.
• Persistent immune reaction: The body cannot easily dissolve cellulose-based plant material. Instead, immune cells may continue reacting around the fragments, producing painful inflammatory nodules, or granulomas, as the material shifts.
Approaches Supported in the Medical Literature
When cactus material has been embedded for years and appears to be causing a tracking reaction, topical creams or simple removal attempts may not be enough. Case reports describe two more targeted approaches.
Option A: Punch Excision
For chronic cactus granulomas, some reports describe punch excision as an effective treatment approach.
Rather than searching for a microscopic spine fragment with tweezers, a clinician uses a small circular punch biopsy tool, often 3 mm to 5 mm, to remove the affected cylinder of tissue. This may include the inflamed mass, the track, and embedded fragments. The area can then be closed with stitches. In reported cases, this approach may relieve pain and inflammation relatively quickly when the foreign material is fully removed.
Option B: Advanced Imaging
Because clinicians cannot remove what they cannot locate, advanced imaging may be useful in complex cases. Optical coherence tomography (OCT) or high-frequency musculoskeletal ultrasound, often 15 MHz or higher, can help identify the depth and path of suspected plant fragments before any procedure is performed.
Specialists Who May Be Better Equipped to Help
If general dermatology has not resolved the issue, it may help to seek clinicians who regularly evaluate complex foreign bodies, deep tissue reactions, or surgical removal of embedded material.
• Academic medical center: A university hospital or research medical center may have specialists and imaging tools suited to complex cases. Consider asking for a dermatologic surgeon or Mohs micrographic surgeon who is experienced with precise removal of abnormal or embedded tissue.
• Orthopedic hand or extremity surgeon: If the injury involves the hand, fingers, arm, foot, or a joint, an orthopedic extremity specialist may be appropriate. These surgeons often manage deep-space foreign bodies involving tendons, fascia, or muscle.
• Infectious disease specialist: If the reaction has persisted or spread for years, an infectious disease specialist may evaluate for slow-growing organisms that can be associated with plant injuries, such as atypical bacteria or fungi. They may also order deep-tissue cultures when appropriate.
Suggested Language for the Next Appointment
When contacting an academic surgeon or specialist, clear medical language may help communicate the concern more effectively:
“I have a chronic, tracking foreign-body granulomatous reaction from a deep cactus spine injury that has persisted for years. It is causing migrating subcutaneous nodules. I would like an evaluation for possible surgical unroofing, micro-excision, punch biopsy, or image-guided removal to address any retained organic material.”