2003
DOI: 10.1046/j.1365-2230.2003.01364.x
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Co-existing sensitivity to metronidazole and isothiazolinone

Abstract: A 68-year-old woman developed allergic contact dermatitis to topical metronidazole gel as proven by positive patch tests to the gel and to metronidazole. She was also allergic to methylchloroisothiazolinone and methylisothiazolinone (MC/MI). The similarity between the two molecules and the fact that the patient reacted to the gel after the very short incubation period of 1 day (i.e. not long enough for acquiring an active sensitization) makes the possibility of a cross-reaction between these substances very pl… Show more

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Cited by 17 publications
(18 citation statements)
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“…In the few reports of ACD caused by imidazoles/nitroimidazoles and isothiazolinones, possible cross-reactivity between MI and metronidazole based on structural similarity was not excluded. 4,5 According to the definition of Benezra and Maibach, 10 among our nine patients (Supporting Information Table S1), cross-reactivity between MCI/MI and imidazoles/nitroimidazoles could be considered in the patients who denied any past use of imidazoles/nitroimidazoles (patients 3, 6, and 9). In the patients who denied past use of the antifungals but who had positive patch test reactions (patients 1, 2, and 4), and in those who declared that they had tolerated past use of the same molecule but who had positive patch test reactions (patients 5, 7, and 8), co-sensitivity is difficult to discern from crossreactivity.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In the few reports of ACD caused by imidazoles/nitroimidazoles and isothiazolinones, possible cross-reactivity between MI and metronidazole based on structural similarity was not excluded. 4,5 According to the definition of Benezra and Maibach, 10 among our nine patients (Supporting Information Table S1), cross-reactivity between MCI/MI and imidazoles/nitroimidazoles could be considered in the patients who denied any past use of imidazoles/nitroimidazoles (patients 3, 6, and 9). In the patients who denied past use of the antifungals but who had positive patch test reactions (patients 1, 2, and 4), and in those who declared that they had tolerated past use of the same molecule but who had positive patch test reactions (patients 5, 7, and 8), co-sensitivity is difficult to discern from crossreactivity.…”
Section: Discussionmentioning
confidence: 99%
“…1 Adverse effects are relatively rare 2 ; in particular, allergic contact dermatitis (ACD) is comparatively rare, considering the high prescription rates. 3 In a few cases of ACD caused by metronidazole 4,5 and clotrimazole, 6 , sensitivity to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) coexisted. MI at the same concentrations as in the commercial blend (0.015% aq.…”
mentioning
confidence: 99%
“…There are only five case reports of contact dermatitis caused by topical metronidazole in the literature. [146][147][148][149] Cross-reactivity to imidazole antifungals has been reported. Izu et al 150 reported a patient with tinea pedis who developed severe dermatitis following treatment with tioconazole cream.…”
Section: Macrolidesmentioning
confidence: 99%
“…Metronidazole is an imidazole derivative used against parasites and anaerobic bacteria which seldom causes allergic contact dermatitis (1–4). Diphenhydramine hydrochloride is an H 1 receptor antagonist, which rarely can trigger allergic and/or photoallergic contact dermatitis (5–9).…”
Section: Discussionmentioning
confidence: 99%