Dexpanthenol is an analogue of pantothenic acid (vitamin B 5 ) that is used in pharmaceuticals and cosmetics. 1 Pantothenic acid is essential for the synthesis of coenzyme A in cells involving in the Krebs cycle.
CASE REPORTA 49-year-old Caucasian man presented with generalized eczema of the trunk and limbs that had lasted for~10 days. Eight weeks before, he had sustained a few scratches on the right leg caused by plants during occupational gardening. He reported having applied a dexpanthenol-containing cream, and, a few days later, he developed local erythema and vesicles, with subsequent spreading.Allergic contact dermatitis caused by the topical drug was considered. Use of the cream was stopped, and the patient was treated with oral prednisolone. After rapid improvement, topical methylprednisolone aceponate cream was prescribed to achieve complete remission. However, the patient mentioned worsening of the residual dermatitis after applying the latter cream, and stopped using it. Physical examination showed an itchy erythematous desquamative plaque on the right leg (Supporting Information Figure S1).Patch testing with IQ Ultra chambers was performed with the Portuguese Contact Dermatitis Research Group baseline series, a cosmetics and excipients series (Chemotechnique Diagnostics, Vellinge, Sweden), and the dexpanthenol-containing cream used, tested "as is." Readings were performed on day 3 according to European Society of Contact Dermatitis guidelines, and showed positive reactions to cetearyl alcohol 20% pet., dexpanthenol 5% pet., and the dexpanthenol-containing cream. Both ingredients were present in the dexpanthenol-containing cream, and cetearyl alcohol was also present in the methylprednisolone aceponate cream (Figure 1).