No abstract

Only six previous cases of ACD in response to topical diltiazem have been reported 1,3,[5][6][7][8] (Table S1), with generalized dermatitis in severe cases. 1,3,5 Systemic allergic dermatitis may appear as a maculopapular eruption resulting from the absorption of diltiazem through perianal skin and mucosa. 1,3 In these patients, it is suggested that oral diltiazem be avoided, and that chemically unrelated CCBs should be used with caution, as cross-sensitivity has been reported. 3 Our patient was additionally sensitized to Myroxylon pereirae and multiple fragrances, likely from previous exposure to fragrances in cosmetics and other products; the use of Anusol preparations may have contributed to the dermatitis.To our knowledge, this is the first published report of cosensitization to both diltiazem and GTN.