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A 96% ethanol extract of tulip bulbs or an extract prepared by shaking fresh bulbs for 90min in acetone (80% in water) using 1% of this extract in 70% ethanol was recommended by Hjorth et al.59 A methanol extract of the fresh petal or leaf/stem material in petrolatum at a 0.001% concentration was recommended by Hausen et al.58 A 6-tuliposide A at 0.01% or an -methylene--butyrolactone at 0.0001% in ethanol was proposed by Santucci et al.51 Patients with allergic contact dermatitis to Alstroemeria generally cross-react with tulip extracts.57,60 No cross-reactions between the sesquiterpene lactones and tulipalin A have been reported (even though both contain an -methylene--butyrolactone in the lactone ring61)