Table 2.
Case reports of new contact allergens identified in pharmaceutical agents following skin exposure. ACD, allergic contact dermatitis; F, female, M, male; age in parentheses. LTT, lymphocyte transformation test; NT, not tested; TTS, transdermal therapeutic system. Patch tests usually read on day (D)3, D4, or D7.
| Substance | Patients | Clinical Problem | Patch Test | Comment | Ref. |
|---|---|---|---|---|---|
| N-Acetylcysteine | 1 F (32) nurse | Hands, arms, face dermatitis | 10% pet: + | LTT also positive | [252] |
| ϵ-Aminocaproic acid | 1 F (78) Japanese | Periorbital ACD due to sodium hyaluronate ophthalmic solution | 1 and 2% aq.: + | [253] | |
| Brimonidine tartrate | 2 M (50,60) | Face dermatitis after Mirvaso® gel | Gel “as is”: neg. resp. (1) | ROAT pos. too | [254] |
| Camphorquinone | 1 M (30) | Contact stomatitis after periodontal dressing | 1% pet.: +++ | [255] | |
| Chlorhexidine | 82/8497 pos. | Antiseptics > cosmetics | 2 salts used. (2) | Accidental, symptomatic re-exposure | [256] |
| Codeine (and naloxone) | 2 F (38,58) | ACD in pharmaceutical workers | 5% pet.; naloxone 10% pet.: +, + | No reactions to synthetic opiates | [257] |
| Efinaconazole | 1 M (74) | Toe dermatitis after antifungal solution | Solution “as is”: ++; 10% pet.: + | [258] | |
| Ketotifen (eyedrops) | 1 F (32) | 3 years chronic conjunctivitis | 0.7% aq. and 2.5% pet.: + and ++ | [259] | |
| Methyl aminolaevulinate | 1 F (53) KID syndrome | Local and systemic dermatitis after PDT | Metvixia® “as is”: ++, MAL 21% pet. + | [260] | |
| Olaflur | 1 F (35) | Cheilitis for 9 months | Toothpaste 1% aq., ++, olaflur ++ | Olaflur concentration not disclosed | [261] |
| Ozonated olive oil | 2 F (23) | (a) Cheilitis (b) foot dermatitis | (a) neg. (b) ++ to product | Irritant reactions in controls | [262] |
| Polymyxin B | 18/795 pos. | 12/18 past exposure | Polymyxin B sulfate 3% pet. | 2.3% pos. in consecutive pat. | [263] |
| Rotigotine | 1 (69) with Parkinson’s dis. | ACD under TTS | 10% pet. ++ | Placebo TTS neg. in ROAT | [264] |
| Sirolimus | 1 F (32) | Localised ACD | Rapamune® “as is” and 1:3 aq.: +++/+ | After after laser treatment of port wine stain | [265] |
| Tea tree oil | 1 F (32) | ACD after applying burn gel | Multiple extracts, incl. Melaleuca alternifolia 5% pet.: ++ | Burns induce barrier dysfunction, increasing risk | [266] |
| Thebaine (and oripavine) | 1 M (35) | ACD in pharmaceutical worker | 5% aq.: ++ and +, resp. | Morphine and noscarpine neg. | [267] |
| Tobramycin | 2 F (35,59), 1 M (66) | Eyelid dermatitis after ophthalmic ointments | 20% pet.: + to ++ | Not detected by neomycin | [268] |
| Turmeric (Curcuma longa) | 1 F (60) | Localised dermatitis after massage oil | 0.01% wt/wt pet. ++ | Also common spice and dye | [269] |
(1) Only early readings positive (+ and ++, resp.), late main reading negative; brimonidine tartrate 0.5% aq. negative. (2) Both chlorhexidine diacetate and chlorhexidine digluconate tested, first half of study period 1% aq., second half 0.5% aq.