A case of allergic contact dermatitis caused by Olanedine solution—A diagnostic patch‐testing method involving dried filter paper

Abstract

Background Olanedine solution is a new antiseptic, and several cases of allergic contact dermatitis caused by the agent were reported in 2018; however, these cases were diagnosed based on positive results in 2‐day closed patch testing of Olanedine solution “as is.” Objectives To present another case of Olanedine‐induced allergic contact dermatitis and to analyze the optimal patch‐testing method for this condition. Methods A 34‐year‐old Japanese female patient and 25 healthy control subjects were patch tested using wet filter paper, which had been treated with 15 μL Olanedine solution, and dried filter paper, which had been treated with 15 μL Olanedine solution and then dried. Results The patient and all of the control subjects exhibited false‐positive reactions due to irritation in the 2‐day closed patch tests with wet filter paper containing Olanedine solution “as is.” The tests with dried filter paper produced a positive reaction on day 7 in the patient, and negative reactions in all control subjects. Conclusions It is preferable to perform 2‐day closed patch tests using filter paper with the test solution “as is,” which had been dried before application in order to correctly diagnose antiseptic‐induced allergic contact dermatitis.

Severe irritant contact dermatitis from olanexidine gluconate and subsequent skin sensitization

“…After the skin lesions had healed, 48‐hour patch tests with olanexidine gluconate were performed, “as is” dried on filter papers, according to a previously described method by Iijima, et al, 4 and the results were read, according to ICDRG criteria, on D2, D3, and D7 or D8 (Figure 1D). The previously used patch test method regarding olanexidine gluconate was found to be reliable in demonstrating skin sensitization to this biguanide, and the patch test reactions, which went crescendo in both cases, also had an allergic morphology: in Case 1 (+D2/++D3) and in Case 2 (–D2/–D3/?+D8).…”

“…It has marked bactericidal effects against a wide range of bacteria, including methicillin‐resistant Staphylococcus aureus and vancomycin‐resistant enterococci 1 . Several cases of contact dermatitis caused by olanexidine gluconate have been reported since 2018 2‐4 . Here, we report two cases of olanexidine gluconate–induced irritant contact dermatitis (ICD) with subsequent skin sensitization.…”

Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

“…The overall incidence of adverse events in OLG was very low, ranging from 2% to 5.8%. 26 , 52 , 56 , 57 , 59 , 60 , 61 Erythema, dermatitis, and pruritus each accounted for approximately 1.0%–1.9% of adverse events. 26 , 52 , 59 , 61 The time of appearance of skin rash was approximately 3–17 days (median, 7 days) after application 60 (Table 6 ).…”

“… 26 , 52 , 56 , 57 , 59 , 60 , 61 Erythema, dermatitis, and pruritus each accounted for approximately 1.0%–1.9% of adverse events. 26 , 52 , 59 , 61 The time of appearance of skin rash was approximately 3–17 days (median, 7 days) after application 60 (Table 6 ). The severity of the disease ranged from mild to moderate, with some cases of spontaneous resolution and resolution after oral antihistamine or topical corticosteroid use.…”

“…The severity of the disease ranged from mild to moderate, with some cases of spontaneous resolution and resolution after oral antihistamine or topical corticosteroid use. 26 , 52 , 56 , 57 , 59 , 60 , 61 …”