Allergic Contact Dermatitis with Diffuse Erythematous Reaction from Diisopropanolamine in a Compress

Abstract

Compresses containing a nonsteroidal antiinflammatory drug (NSAID) are commonly used in Japan. However, this treatment may induce both allergic and photoallergic contact dermatitis from the NSAIDs and their ingredients. Here, we describe a case of allergic contact dermatitis with diffuse erythematous reaction due to diisopropanolamine in the applied compress. The absorption of diisopropanolamine might have been enhanced by the occlusive condition.

Allergic Contact Dermatitis from Diethyl Sebacate in a Topical Antimycotic Medicament

“…Allergic contact dermatitis from topical medicaments has been reported in cases caused by 1) effective drugs such as clotrimazole [12] and luliconazole [13]; 2) additives including parabens [14], 1,3-butylene glycol [15], enoxolone [16], diisopropanolamine [9,10], and menthol [7]; and 3) solvents like lanoline alcohol [17]. The trend of the sensitized frequencies has been studied in the well known allergens such as parabens [18,19] and lanolin alcohol [19,20].…”

Review of Allergic and Photoallergic Contact Dermatitis from an Ingredient in a Medicament Vehicle Consisting of a Compress, Poultice, Plaster, and Tape

“…Case 2 was an 87-year-old Japanese male with a rectangular erythema on the bilateral lower back and the buttock and a diffuse erythema on the trunk and extremities caused by allergic contact dermatitis from the diisopropanolamine in the compresses that he used (Figure 3) [15]. …”

“…The effective components, an NSAID [ 6 ] or methyl salicylate [ 8 ], have been shown to be allergens. Additives, such as crotamiton [ 6 ], diisopropanolamine [ 6 , 10 , 15 ], l-menthol [ 12 , 14 ], paraben [ 7 ], and modified resin [ 11 , 12 ] also have been shown to be allergens. Benzalkonium chloride usually induces irritant contact dermatitis, but rarely induces allergic contact dermatitis [ 5 , 16 – 18 ].…”

“…Some cases may show a rectangular eruption with a diffuse erythematous [ 6 ] or erythema multiform-like generalized reaction [ 14 ]. Case 2 was an 87-year-old Japanese male with a rectangular erythema on the bilateral lower back and the buttock and a diffuse erythema on the trunk and extremities caused by allergic contact dermatitis from the diisopropanolamine in the compresses that he used ( Figure 3 ) [ 15 ].…”

“…It may also contain dl-camphor for relief of peripheral pain, l-menthol for peripheral cooling, and other ingredients, such as paraben, modified rosin, oxybenzone, and diisopropanolamine. We summarize cases of allergic and photoallergic contact dermatitis from an ingredient that were reported during the last decade [ 1 – 15 ].…”