Allergic contact dermatitis to topical medicaments: Revisited

Thaiwat, Supitchaya; PhayangkheUbol, Taksaorn

doi:10.12932/ap-180820-0944

Cited by 2 publications

(2 citation statements)

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“…Allergic contact dermatitis can also occur with topical medications ( 52 , 53 ), such as topical antibiotics ( 54–56 ), antiacne drugs ( 57 ), anesthetics ( 58 , 59 ), antihistamines ( 60 , 61 ), testosterone and estrogen from the transdermal therapeutic system ( 52 ), antimycotics ( 62–64 ), sunscreens ( 65–67 ), NSAIDs ( 68 , 69 ) corticosteroids (CS) ( 52 , 70 ).…”

Section: Allergensmentioning

confidence: 99%

Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches

et al. 2023

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Allergic contact dermatitis (ACD) is a common inflammatory skin disease that, especially when the condition becomes chronic, has a high impact on the quality of life and represents a significant disease burden. ACD represents a type IV delayed-type hypersensitivity reaction that is triggered by contact with an allergen in previously sensitized individuals through the activation of allergen-specific T cells. In the acute phase, it is characterized by eczematous dermatitis, which presents with erythema, edema, vesicles, scaling, and intense itch. Non-eczematous clinical forms are also described (lichenoid, bullous, and lymphomatosis). Lichenification is the most common clinical picture in the chronic phase if the culprit allergen is not found or eliminated. ACD can be associated with both occupational and non-occupational exposure to allergens, representing approximately 90% of occupational skin disorders along with irritant contact dermatitis. Patch testing with suspected allergens is required for a diagnosis. Metals, especially nickel, fragrance mix, isothiazolinones, and para-phenylenediamine, are the most commonly positive allergens in patients patch tested for suspected ACD. The treatment goal is to avoid contact with the culprit agent and use topical and/or systemic corticosteroid therapy.

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Section: Allergensmentioning

confidence: 99%

Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches

et al. 2023

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“…Other notable non-NACDG allergens found in topical medicaments include minoxidil, 29 tacrolimus, 30 pimecrolimus, 31 crisaborole, 32 framycetin, 33 and medications in transdermal patches (eg, clonidine [34][35][36] ).…”

Section: Supplemental Allergensmentioning

confidence: 99%

Patch Test Reactions Associated With Topical Medications: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001–2018)

et al. 2021

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Background/ObjectivesTopical medications may lead to allergic contact dermatitis. This study characterized positive patch test reactions associated with medications in patients evaluated by the North American Contact Dermatitis Group (NACDG).MethodsThis study is a retrospective analysis of the NACDG data (2001–2018). Patients with at least 1 positive patch test reaction associated with a medication source were included. Allergens, reaction characteristics, clinical relevance, and source details were tabulated.ResultsOf 43,722 patients, 6374 (14.6%) had positive allergic patch test reactions associated with 1 or more topical medication sources. Patients with versus without allergic reactions to medications were more likely to be older than 40 years (P < 0.0001) and/or have primary sites of dermatitis on the legs, anal/genital region, or trunk (P < 0.0001). There were 8787 reactions to NACDG allergens; the most common were neomycin (29.4%), bacitracin (29.1%), propylene glycol 100% (10.6%), tixocortol-17-pivalate (10.0%), lidocaine (7.9%), budesonide (4.9%), and dibucaine (4.4%). Propylene glycol 100% was the most common inactive ingredient (10.6%). Current relevance was present in 61.0%. A total of 6.5% of the individuals with medication allergy would have had 1 or more positive patch test reactions missed if only tested to the NACDG screening series.ConclusionsPositive patch test reactions associated with topical medications were common (14.6%), and most were clinically relevant. Patients with topical medication allergy were twice as likely to have anal/genital involvement. Active ingredients, especially neomycin, bacitracin, and tixocortol-17-pivalate, were frequent culprits.

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Allergic contact dermatitis to topical medicaments: Revisited

Cited by 2 publications

References 0 publications

Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches

Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches

Patch Test Reactions Associated With Topical Medications: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2001–2018)

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