Clinicopathologic Features of Systemic Contact Dermatitis from Ethylenediamine in Cetirizine and Levocetirizine

Cusano, Francesco; Ferrara, Gerardo; Crisman, Giuliana; Sarracco, Giovanni; Zalaudek, Iris; Argenziano, Giuseppe

doi:10.1159/000096203

Cited by 15 publications

(3 citation statements)

References 12 publications

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“…Systemic CD may occur from ethylenediamine dihydrochloride in oral/parenteral aminophylline or cross-reactions with oral antihistamines (eg, cetirizine, levocetirizine, antazoline, hydroxyzine). 3 Skin reactions due to cobalt may occur with intramuscular injections or oral ingestion of vitamin B 12 . 4 Carmine is used as a coloring agent in medications.…”

Section: Discussionmentioning

confidence: 99%

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Patch Test Reactions Associated With Nontopical Medications: A Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2018

et al. 2021

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We recently presented data on contact dermatitis (CD) to topical medications. 1 Here, we present data on nontopical medications (NTMs) using the same methodology. 1 Nontopical medications included oral and parenteral (nontopical) routes of administration (eg, lidocaine in transdermal patch/ointment formulations was excluded, but lidocaine in intramuscular/ intravenous formulations was included). Patients with 1 or more positive patch test reactions associated with an NTM comprised the NTM group. RESULTSOf 43,722 patients, 234 (0.5%) had 1 or more NTM-associated positive patch test reactions. The majority were women (71.4%, 167 of 234) or older than 40 years (71.8%, 168 of 234; Table 1). The most common primary anatomic sites in the NTM patients were scattered generalized distribution (28.2%), the face (24.4%), and the hand (17.1%). Results were similar when up to 3 body sites were considered (Table 1).Of the 234 NTM patients, 174 (74.4%) had reactions to North American Contact Dermatitis Group (NACDG) screening allergens only; 60 (25.6%) had NTM-associated reactions to supplemental allergen/substances. Of the 182 NTM-associated reactions to NACDG screening allergens, most common were thimerosal, ethylenediamine dihydrochloride, cobalt chloride, carmine, potassium dichromate, lidocaine, tocopherol, and sodium metabisulfite (Table 2). Most reactions (64.3%, 117 of 182) were clinically relevant (definite, 9; possible, 58; probable, 50). Past clinical relevance was high for thimerosal (90.5%, 38 of 42), dibucaine (71.4%, 5 of 7), and lidocaine (57.1%, 8 of 14).A.R.A. received a Pfizer Independent Grant for Learning & Change and has consulted for Henkel. J.S.T. owns noncontrolling common shares of stock in AstraZeneca, Cigna, Merck, Johnson & Johnson, and OPKO Health. He has consulted for Kao Brands and Monsanto (Bayer), is a member of the Cosmetic Ingredient Review Steering Committee, and has a nondependent child employed by Pfizer, Inc. E.M.W. has received an investigator-initiated grant from and served as a consultant for Wen by Chaz Dean. She has also served as a consultant to Noven Pharmaceuticals. D.S. receives royalties from UpToDate

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Section: Discussionmentioning

confidence: 99%

“…Because of the concerns of mercury toxicity, thimerosal has been removed from most US childhood vaccines. Systemic CD may occur from ethylenediamine dihydrochloride in oral/parenteral aminophylline or cross-reactions with oral antihistamines (eg, cetirizine, levocetirizine, antazoline, hydroxyzine) 3 …”

Section: Discussionmentioning

confidence: 99%

Patch Test Reactions Associated With Nontopical Medications: A Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2018

et al. 2021

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“…Antihistaminikapräparationen können zu einem allergischen Kontaktekzem oder zu einer Photosensibilisierung führen [6,39]. Die Wirkung besteht wahrscheinlich nur in der Kühlung der meist benutzten Gelgrundlage, während ein direkter Effekt der Antihistaminika auf die Pathologie der Verbrennung nicht besteht [33].…”

Section: Bedeutung Der Kühlungunclassified

Rationale Behandlung von Patienten mit Verbrennungen 1. Grades

et al. 2007

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First-degree burns are the most common type of burn, but are often inadequately treated. The methods of treatment and the course of healing are poorly documented owing to the fact that first-degree burns are generally not considered to be a serious injury. First-degree burns can be caused by thermal injury or UV irradiation (sunburn). The pathophysiology and the therapeutic approach are similar, although the damage follows a different time course for each injury--immediate damage after contact with hot objects, liquids or fire, delayed damage after sun exposure. After initial cooling with water, aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are best suited for treating first-degree burns or sunburn. Water evaporates producing cooling and reducing inflammation; the lipids accelerate the repair of the damaged skin barrier and reduce drying. Foam sprays and lotions are ideal because they are easy and painless to apply. The use of topical corticosteroids is not recommended, as superiority to the vehicle has not been shown.

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Allergic Contact Dermatitis

Wilkinson,

Orton

2016

Rook's Textbook of Dermatology, Ninth Edition

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Allergic contact dermatitis is the classic delayed hypersensitivity reaction, developing in two phases – sensitization and elicitation. It can have profound effects on affected individuals and may result in sickness, absence from work and increased health expense. Its diagnosis requires consideration of many factors including the patient's history and a physical examination; knowledge of the skin's reaction to various chemicals is also desirable. Above all, it requires a high degree of suspicion on the part of the clinician and tenacity, skill and experience in the investigator. The diagnosis can only be confirmed by interpreting patch test results and the technique in itself has many pitfalls for the unwary. Any sensitization identified needs to be put into the context of a past or present dermatitis, and explanations for allergen avoidance or substitution need to be provided for the patient.

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Clinicopathologic Features of Systemic Contact Dermatitis from Ethylenediamine in Cetirizine and Levocetirizine

Cited by 15 publications

References 12 publications

Patch Test Reactions Associated With Nontopical Medications: A Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2018

Patch Test Reactions Associated With Nontopical Medications: A Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2018

Rationale Behandlung von Patienten mit Verbrennungen 1. Grades

Allergic Contact Dermatitis

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