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Phenolformaldehyde resins are an important cause of contact dermatitis and must be studied chemically and clinically to improve the prognosis of sensitized patients.

In March 1990, a 44-year-old woman presented with eczema of the heel and posterior aspect of her left leg. She had suffered from poliomyelitis since childhood and there was marked muscular hypotrophy of the left leg. Since 1988, she had been using a Codivilla spring (Fig. 1), an orthopedic device used to support swinging feet. Unfortunately, an itchy Fig. I. Codivilla's spring. Table I p-tert-butylphenol 2% pet. phenol-formaldehyde resin 5% pet. dermatitis developed where the device touched the skin. When she stopped using the Codivilla spring, her dermatitis resolved, but when she tried to use it again, as she could not do without it, the dermatitis recurred.Cutaneous examination showed 2 erythemato-vesicular areas in the sural and calcaneal region of the left leg. The lesions had the exact shape of the spring. The patient was patch tested with the GIRDCA standard series. Patch tests with para-tertiary-butylphenol-formaldehyde resin (PTBP-FR) I% pet. and thimerosal 0.1% pet. were strongly positive ( + + +) at 2 and 4 days. A patch test with a shaving of the leather covering with some adhesive on it was also strongly positive. The patient was then patch tested with a series of phenol-formaldehyde resins (Table 1): she showed positive reactions to phenol-formaldehyde resin 5% pet. ( + + +) and to urea-phenolformaldehyde resin 10% pet. (++),while the other resins remained negative. DiscussionCodivilla's spring is an orthopedic foot device, made to measure, with a spring inserted in the posterior D2 D4 ++ +++ toluene sulfonamide-formaldehyde resin I 0% pet. dimethylolhydroxyethylene urea 10% pet. urea-phenol-formaldehyde resin 10% pet. hexamethylenetetramine I% pet. ++ ++ resorcin 1% pet. resorcinol mono benzoate 1% pet. 2-monomethylol phenol I% pet.