Allergic contact dermatitis to silver in a patient treated with silver sulphadiazine after a burn

Health Impact of Silver Nanoparticles: A Review of the Biodistribution and Toxicity Following Various Routes of Exposure

“…It is well known that patients with wounds are at particular risk of developing either an allergic or irritant contact dermatitis, and silver compounds are widely used in wound care. However, so far, there have been very few confirmed cases of contact dermatitis secondary to silver-containing wound products like silver sulfadiazine and skin markers that contain silver nitrate [187,188]. Contrary, there is considerable evidence for the significant transdermal penetration of AgNPs into capillaries during the use of surgical dressings, textiles, and cosmetics [189,190].…”

Silver: An underdiagnosed allergen?

“…11 There are few published cases of ACD confirmed by patch test with silver nitrate 2-4,6-9 or silver fulminate. 5 To our knowledge, our case would become the seventh reported case of ACD due to silver sulphadiazine cream [7][8][9]11 and it would be the fourth case confirmed by silver patch testing, probably because of its presence in silver sulphadiazine. One case displayed a concomitant sensitization to colophonium 3 or to cetyl alcohol; 9 concomitant sensitization to propylene glycol was also found in our patient.…”

“…Silvederma cream (containing silver sulphadiazine) is a topical antibacterial agent prescribed for the treatment and prevention of infections in second and third degree burns as well as in chronic ulcers. Reported cutaneous side effects by silver or silver sulphadiazine include hypersensitivity reactions, 1 ACD, [3][4][5][6][7][8][9][10][11] erythema multiforme, 12 and cutaneous and systemic argyria. 13 Despite the widespread use of silver-containing products in wound care, ACD to silver has scarcely been described in the literature.…”

“…6 On the other hand, some cases have been found to be related to the application of silver sulphadiazine under different trade names such as Silvederma cream, Silverdin cream 1% (Deva, Istanbul, Turkey) or Flamazine cream 1% (Solvay, Benburg, Germany), with different excipients. [7][8][9] The patient who used Silverdin developed a subsequent allergic reaction to Chemotechnique Diagnostics skin markers that contained silver in their composition. A case in which a positive "edge effect" at the periphery of the patch test site developed has been reported, although contact allergy could not be confirmed by patch testing but was diagnosed based on the clinical presentation and a biopsy.…”

Herpes Zoster Manifestation in the Treatment of a Facial Scald Burn: A Case Report

“…However, the clinical diagnosis was herpes zoster based on the patient's age, the statement that fatigue with stress had continued recently, the fact that pain and itching were limited to the face, and the formation of new blisters in unburned areas. Contact dermatitis, commonly seen during burn treatment, was easily ruled out according to the fact that new blisters were seen in untreated regions and the dressing materials were not changed at all during the whole treatment course [10,11]. In addition to preventing secondary infection, along with eliciting a thorough medical history, the zone of stasis should be monitored to see whether it progresses to a deeper burn despite careful dressing, considering the process of "burn wound conversion."…”