Systemic Allergic Dermatitis After Patch Testing with Dibucaine and Topical

University of Southern Denmark

Systemic allergic dermatitis after patch testing with cinchocaine (dibucaine) and topical corticosteroids

Alves da Silva, Catarina; Paulsen, Evy

Published in: Contact Dermatitis

DOI: 10.1111/cod.13290

Publication date: 2019

Document version: Accepted manuscript

Citation for pulished version (APA): Alves da Silva, C., & Paulsen, E. (2019). Systemic allergic dermatitis after patch testing with cinchocaine (dibucaine) and topical corticosteroids. Contact Dermatitis, 81(4), 301-303. https://doi.org/10.1111/cod.13290

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Key words: Key words: Systemicallergic dermatitisafter patch testing with 1) Department of Dermatology and Allergy Centre Allergy and of Dermatology Department furoat case report dibucaine and topical corticosteroids University of Southern Denmark Southern of University 111/cod.13290 e; e; patch test; systemic allergic dermatitis; phenylephrine phenylephrine dermatitis; allergic test;systemic ; patch Department of Dermatology and Allergy Centre Centre Allergy and of Dermatology Department ; dibucaine Email: [email protected] Email: [email protected] Telephone number: +45 6541 2705 2705 6541 +45 number: Telephone Conflict of interests: none declared. declared. none Conflict of interests: University of Southern Denmark Denmark Southern of University Odense University Hospital Hospital Odense University Catarina Alves daSilva Alves Catarina -5000 Odense C OdenseC DK-5000 corticosteroids; drug hypersensitivity; drughypersensitivity; ; corticosteroids; Correspondence Correspondence Catarina Catarina A. Silva Evy Paulsen Denmark Denmark

and the Versionof Record. Please cite this 1 1 , Odense C Odense

1 1 , Odense University Hospital University Odense , Denmark Denmark mometasone mometasone , This articleisprotected bycopyright.Allrightsreserved. Accepted Article The acetonid anti several aneurysm. cerebral cataract for examined being after contact 69 A report Case reported allergen an with contact cutaneous by route different a by allergen reacting cross a or allergen same the dermatitis allergic Systemic numerous sensitizations to topical corticosteroids of different groups, and the the and groups, different of reaction corticosteroids topical sites test patch the to cream furoate mometason of application to sensitizations numerous positive r Systemic is because it forchosen treatment sensiti was she that doubt no is there suspected areas. unaffected previously Despite Discussion described. was reaction no systemic but face, her of area larger a in dermatitis of flare a caused This eczema. facial localized used having after later months 8 About the later weeks Three zinc ointment. as aswell again, once was prescribed pivalate tixocortol not was prednisolone systemic with invo axill posterior eczema consultation, emergency the and dermatitis as interpreted or sun erythematous hydrochlorid and pruritus reactions test patch was patient The dibucaine corticosteroids 17 (MI) (MCI)/methylisothiazolinone and some as 3 phenylephrine containing Sweden) Arizona) Vellinge, Diagnostics, Smartpractice, (AllergeEaze,

showed -

department ofdermatology department butyrate and and butyrate - ain was patient year

plcto o tpcl rdcs n h afce aes Te rsnain was presentation The areas. affected the in products topical of application She allergy. . treatment, the treatment, e aller reaction to dibucaine suggests that t that suggests dibucaine to reaction 3 .

4 gel - We hypothesize that the sensitization route occurred during previous previous during occurred route sensitization the that hypothesize We pos We report a case of a case We report atos o dibucaine to eactions . old woman was referred to our department department our to referred was woman old

- In view of the patient’s later clinical reaction to mometason to reaction clinical later patient’s the of view In

hemorrhoid ointments. More recently, the pa the recently, More ointments. hemorrhoid gens of the baseline series baseline the of gens

for i ar folds, wrist, inner side of b of side inner wrist, folds, ar t

ive and

eczema in the ear. ear. in the eczema

prescribed prescribed mometason

tested tested MI eczema patch test reaction test patch and hence possible cross possible hence and

of topical of topical

and and had had In connection with with connection In , the patient was again referred again was patient the , .

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had resolved had tested “as is” “as tested exanthema arises if an if arises t D8 at anesthetics e Hence, m s , to further follow further , to ystemic ystemic

furoat the ometason s el as well as

( . a rare cause of contact allergy of contact cause rare a cinchocaine ,

Her past medical history included hypertensio included history medical past Her

tixocortol

f h frt test first the of .

aeie series baseline

Two days later, the patient patient the later, days Two an attractive option option attractive an a e s s was

of the back the of ed to this corticosteroid as well, although it was was it although well, as corticosteroid this to ed : caine mix, caine : cream, prescribed by her general practioner, for for practioner, general her by prescribed cream, to both phenylephrine and Metaoxedrin, Metaoxedrin, and phenylephrine both to a systemic systemic , although transepidermal rechalle transepidermal although ,

under occlusion under individual llergic llergic and the patient was therefore therefore was patient the and , respectively , childbirth

additionally furoat an ophthalmic ophthalmic an oth thighs and and thighs oth hnlprn ad Metaoxedrin and phenylephrine lved lved - reactivity, reactivity, - his compound, compound, his 21 ) e 8 d , pruritic ), ), 9 ion of ion - - ermatitis ermatitis

pivalate, pivalate, legc yesniiiy reaction hypersensitivity allergic up with the general practitioner. general the with up e the antecubital fossae, anterior and and anterior fossae, antecubital the

ae en reported been have

and arms. arms. and

(benzocaine, tetracine hydrochl tetracine (benzocaine,

cream sensitised via the skin the via sensitised , including including , m 4 er ag years 44

to the department of dermatology dermatology of department the to . ometason The results are shown in t are shown The results dermatitis

and . erythema and erythema tested with a series of topical topical of series a with tested

Readings performed Readings due to the positive reaction to to reaction positive the to due

tient had applied applied had tient was was caused by patch testing. patchtesting. by caused bu o suspected for methylchloroisothiazolinone methylchloroisothiazolinone anal fold anal m She denied exposure to the the to exposure denied She denoside, hydrocortisone hydrocortisone denoside, perhaps series ometason , advised

ha 5 e , h ptet a used had patient the o, RE TEST TRUE presented presented -

, developing lesions in in lesions developing , 7 furoat s . 1

. . elicited the systemic systemic the elicited

( It is rarely elicited elicited rarely is It Fig. 1 Fig. together with the the with together (Chemotechnique (Chemotechnique .

and the the and o discharged Three days a days Three e cream e e

edema one day day one edema phenylephrine phenylephrine furoat furoat

nge has been been has nge is exposed to to exposed is ) again f . T . luocinolon

ae 1 panel (eyedrops at day ( day at reatment reatment e extreme extreme e

able 1.able

as well well as for the the for

cream, cream, due to to due

cream cream

n and and n

from from rid was was fter fter D - 3 e e )

This articleisprotected bycopyright.Allrightsreserved. Accepted Article t s nsa ta a esn ih n with sensitization person a that unusual is It re parenteral topically or oral to due occur sensiti reactions most that demonstrating Bae corticosteroid a risk canat be corticosteroids including presentations, of range systemic wide a have can corticosteroids to Hypersensitivity and hydrocortisone anti with treatments reported dermatitis individual reaction, dermatitis test patch strong very responsible the allergen primary the be may dibucaine that likely is it Although p to dermatitis contact of amounts furoate mometasone c k et al have studied 315 patients with with patients 315 studied have al et k s ed individuals, with the respective corticosteroids being previously applied applied previously being corticosteroids respective the with individuals, ed 12 .

allergic allergen elicited by elicited allergen, this with treatment local by caused

haptens

o aiu criotri molecules corticosteroid various to

orally, intravenously, intramuscularly, intra intramuscularly, intravenously, orally,

s dermatitis , and during treatment with Synalar ( withSynalar during treatment , and

remains unknown remains . The case demonstrates that transepidermal absorption of small small of absorption transepidermal that demonstrates case The . under occlusion may cause a syste a cause may occlusion under - hemorrhoid ointments, ointments, hemorrhoid patch te patch henylephrine of 10 sting with with sting

. developing Patients with previous contact allergy to topical topical to allergy contact previous with Patients si com skin o

. and the literature of systemic allergic contact contact allergic systemic of literature the and

n y dos has drops eye in To our knowledge, knowledge, our To any of the allergens presented here have been been have here presented allergens the of any

corticosteroid systemic systemic which typically contains both dibucaine dibucaine both contains typically which lit i gnrl shows general in plaints , including to the rare sensitizer sensitizer rare the to including , allergic fluocinolon i reaction mic t

he relative contribution of contribution relative he delayed previously previously no no

- to exposed when dermatitis articular or intra or articular cases of systemic allergic allergic systemic of cases - type hypersensitivity, hypersensitivity, type e acetonid , . en reported been systemic

such a broad broad a such - exposure of of exposure , e

- based on on based nasally )

. allergic allergic

the the 11 13 . .

This articleisprotected bycopyright.Allrightsreserved. Accepted Article References

6. 5. 4. 3. 2. 1. 13. 12. 11. 10. 9. 8. 7.

Baeck M, Goossens A. Systemic contact dermatitis to corticosteroids. corticosteroids. to patch testreaction dermatitis long a with eyedrops, in phenylephrine to due dermatitis contact contact Systemic Tamagawa A. Goossens Allergy. M, Baeck and Features 2017;22:6825 Des. CurrPharm Reactivity. Cross Clinical Corticosteroids: to Allergy Systemic J. Waton A, Barbaud Contact chinchocaine. Immunol RevAllerg Clinic corticosteroids. from F, Ali dermatitis R, Vatti contact systemic 1995;33:443 Dermatitis. and E, dermatitis Faria C, Marques F. Dermatitis Contact Merk B, Sachs S, Erdmann Dermatitis. allergies. corticosteroid topical 2006;17:147 multiple with patient a momet in and furoate desoximetasone to reactions Cross JG. Dekoven JC, Donovan 2008;58:180 cross with al. et J, Tittelbach P, Elsner F, Seyfarth Dermatit Contact contactsensitization. riskof low a have furoate mometasone and propionate Fluticasone MH. Beck SM, Wilkinson 2015;73:317 Dermatitis. prednis by caused dermatitis J, Lambert M, Verheyden DG, Ebo V, Sabato MA, Faber T Zapolanski Jacob S, Dermatitis. Cream. Combination Clioquinol/Hydrocortisone Skotnicki D, Poon F, Mussani Immunology. & Allergy in Reviews Clinical Dermatitis. Contact Systemic G. Rosner M, Aquino

2012; 67:1580 2012; - Mineoka R Mineoka - – – reactivity to group B corticosteroids. Contact Dermatitis. Dermatitis. Contact corticosteroids. B group to reactivity

2019;56:9 181. 151. T euber S, Chang C, Gershwin ME. Hypersensitivity reactions to to reactions Hypersensitivity ME. Gershwin C, Chang S, euber

. .

European Journal of Dermatology. ofDermatology. Journal European 2001;44:260 . Systemic Contact Dermatitis. Contact . Systemic , -

Katoh N Katoh ahd A Gon A, Machado 5 - -

320

- n drvtvs n oe n ear and nose in derivatives one Grant S. Systemic Contact Dermatitis to Topical Topical to Dermatitis Contact Systemic S. Grant , Systemic contact dermatitis from cinchocaine. cinchocaine. from dermatitis contact Systemic - Yoneda K Yoneda 1

Contact allergy to mometasone furoate furoate mometasone to allergy Contact ça . 2014; , Cho Y Cho o M, lo, - 47:26 6831. , is. 1996;34:365 is. Kishimoto S Kishimoto

Dermatitis Gon 2010

Aerts O. Systemic allergic allergic Systemic O. Aerts - ça

37 lo S. Allergic contact contact Allergic S. lo

;20 2013; ; . Systemic allergic allergic Systemic . 2008 :125 - – drops. Contact Contact drops. 24:196 lasting allergic allergic lasting 366. - ;19 6.

:9 – - 15. 197 asone asone

This articleisprotected bycopyright.Allrightsreserved. Accepted Article 1.SupplementaryTable allergens Amcinonide (T)0.1% Desoximetasone 1% pivalate Corticostero Alclometasone Dexamethasone Budenoside Clobetasol Clobetasol Hydrocortisone Hydrocortisone Betamethasone Betamethasone acetonide(T)0.1%Triamcinolone acetonide(C)1% Triamcinolone Dibucaine 5% Hydrochloride Allergen 48hours patch testFigure 1Skineruption after readings Day8 at

1.0% - - 17 17

(T) 0.1% id mix (Budenosideid mix 0.1%, Tixocortol , - - propionate (T)0.25%propionate (C)1% propionate Hydrocortisone - 17,21 - - - - - 17 17 21 17 17 - - - - - valerat (T)0.12%valerat (C)1% valerat phosphate disodium salt

butyrate butyrate

diproplonate (C)1%

(T) 0.1% (C) 1% - 17

butyrate

1% (C) 1% ) 2.1% - 21

Reaction Reaction at

++ + + ++ + ++ ?+ ?+ ?+ + + + + + + + + + +