Contact dermatitis to a carotidian Doppler gel

Ayadi, M.; Martin, P.; Bergoend, H

doi:10.1111/j.1600-0536.1987.tb02681.x

Cited by 10 publications

(11 citation statements)

References 2 publications

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“…Ultrasonic examinations are widespread throughout the world, but only a few cases of contact hypersensitivity to ultrasonic gels have been reported 1–4 . The role of the gel is to fill the space between the surface of the ultrasonic probe and the skin, and no apparent influence on the skin condition is intended.…”

Section: Discussionmentioning

confidence: 99%

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A case of allergic contact dermatitis from propylene glycol in an ultrasonic gel, sensitized at a leakage skin injury due to transcatheter arterial chemoembolization for hepatocellular carcinoma

Horiguchi¹,

Honda²,

Fujii³

et al. 2005

Int J Dermatology

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A 63-year-old man with hepatocellular carcinoma consequent to chronic viral hepatitis C presented with severe dermatitis on the lower right side of the back after transcatheter arterial chemoembolization (TACE) via the 10th intercostal artery, because his hepatic artery had already collapsed due to repeated usage for TACE. The regional skin showed redness and hardness with pustules. Histologically, there was epidermal and appendage necrosis, as well as exocytosis of red blood cells. With a diagnosis of skin injury due to leakage of lipiodol ultrafluid, mitomycin, and epirubicin, administered via the 10th intercostal artery, onto the skin tissue, topical application of 0.06% fluocinonide-containing cream was prescribed. After several weeks of conservative local treatment, the leakage skin injury improved significantly, leaving pigmentation, hardness, and a small necrotic mass, as reported elsewhere (Honda T, Matsushima S, Fujii S, et al. A case of skin injury following transcatheter arterial chemotherapy through intercostal artery for hepatocellular carcinoma. Skin Res 2003; 2: 18-22). Subsequently, the patient again consulted the Dermatology Department with further dermatitis in an almost identical skin region on the right side of the abdomen (irregularly spreading erythematous and edematous eruptions with itching; Fig. 1). As he had undergone an ultrasonic examination 2 days earlier, allergic contact dermatitis from the ultrasonic gel was suspected. The contact dermatitis was treated with a topical corticosteroid hormone-containing ointment. Patch testing was performed with Ultra Phonic Conductivity Gel (Pharmaceutical Innovations Inc., Newark, NJ, USA), with which the patient had undergone a series of ultrasonic examinations, and Sono Jelly (Toshiba Medical Supply Co., Ltd., Tokyo, Japan) as a reference, as well as white petroleum as a negative control. A positive result was obtained for Ultra Phonic Conductivity Gel, whereas Sono Jelly was negative (Fig. 2a). Pharmaceutical Innovations Inc. kindly supplied the ingredients of the gel: propylene glycol (PG), preservative in PG, color in PG, thickener 1, and thickener 2. The company gave no further details about the preservative, color, and thickeners. Patch testing was performed using these five materials, resulting in a positive reaction for PG, preservative in PG, and color in PG. Thickeners 1 and 2 and lipiodol ultrafluid were negative (Fig. 2b). On the assumption that the causative chemical was PG, commercially obtained PG, free of preservative and color, was then patch tested (original, 10% aqueous, 1% aqueous, and 0.1% aqueous solutions), resulting in original strongly positive, 10% positive, and 1% and 0.1% weakly positive (Fig. 2c). The medical records showed that the patient had received 16 ultrasonic examinations with the same ultrasonic gel before the leakage skin injury. The 17th examination was performed 2 days after leakage dermatitis, and the 18th 3 months after the injury, when contact dermatitis occurred. The 19th examination was performed using...

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Section: Discussionmentioning

confidence: 99%

“…Of the four reported cases of contact hypersensitivity to ultrasonic gels, preservatives (methyldibromoglutaronitrile 1,3 and imidazolidinyl urea 2 ) and propylene glycol (PG) 4 have been disclosed to be the causative chemicals. A case showing contact dermatitis to PG in an electrocardiogram electrode gel has also been reported 5 …”

Section: Discussionmentioning

confidence: 99%

A case of allergic contact dermatitis from propylene glycol in an ultrasonic gel, sensitized at a leakage skin injury due to transcatheter arterial chemoembolization for hepatocellular carcinoma

Horiguchi¹,

Honda²,

Fujii³

et al. 2005

Int J Dermatology

View full text Add to dashboard Cite

show abstract

“…Only a few cases of contact hypersensitivity from gel application have been reported. [1][2][3][4][5][6][7][8] During a hands-on ultrasound workshop, we scanned a healthy 29-year-old test person for approximately 30 minutes by using a standard water-soluble viscous ultrasonic gel (Transatlantic Handelsgesellschaft Stolpe & Co. mbH, Wehrheim, Germany). The ingredients of this gel are water, carbomer thickener, sodium hydroxide, propylene glycol, methylparaben, butylparaben, ethylparaben, propylparaben, and isopropylparaben.…”

Section: Allergic Contact Dermatitis Caused By Ultrasonic Gelmentioning

confidence: 99%

“…The issue at hand is, despite several excellent publications that illustrate very clear ultrasound images for popliteal nerve block, such images are often difficult to obtain on the basis of the published methodology. [1][2][3][4][5][6] In our experience, neural structures are not always easy to identify on the ultrasound screen; sometimes what appears to be a neural structure is an artifact. In contrast to this problem, most blood vessels are readily identified by use of ultrasound, and they are often accompanied by corresponding nerves.…”

Section: The Importance Of Ultrasound Landmarks: a "Traceback" Approamentioning

confidence: 99%