Contact dermatitis to ophthalmic solutions

Mughal, A. A.; Kalavala, M.

doi:10.1111/j.1365-2230.2012.04398.x

Cited by 15 publications

(7 citation statements)

References 23 publications

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“…Since eyelid dermatitis can be caused by other skin conditions (ex: atopic dermatitis, seborrheic dermatitis, irritant contact dermatitis, rosacea), patch testing is a valuable tool to establish a differential diagnosis and to identify the culprit allergen 9,10 . Nevertheless, obtaining pure ingredients of topical ophthalmic medications and determining the appropriate concentration and vehicle for testing may be challenging in OftACD 1,2,11 …”

Section: Introductionmentioning

confidence: 99%

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A closer look at allergic contact dermatitis caused by topical ophthalmic medications

et al. 2022

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Background: Allergic contact dermatitis caused by topical ophthalmic medications (OftACD) is frequently difficult to confirm with patch testing and, therefore, it is considered uncommon.Methods: We collected retrospective data from a cohort of 65 patients with suspected OftACD patch tested in our Dermatology Unit (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021) according to ESCD guidelines, using a series of topical drugs and excipients (Chemotechnique Diagnostics), including betaxolol and timolol 5% pet. kindly supplied by the pharmaceutical industry. Also, frequently used ophthalmic medications as well as patient's own products were also patch tested 'as is' in most patients.Results: Positive patch tests to ophthalmic medications occurred in 44 patients (67.7%) (38F/6M; mean age 63.1 years), with 102 positive reactions. Most positive reactions were associated with active ingredients (n = 56), especially aminoglycoside antibiotics (n = 27), followed by excipients (n = 24) such as sodium metabisulfite (n = 7). There were also positive reactions to topical products tested 'as is' (n = 22), mostly containing beta-blockers, but only five of these reacted to the active ingredient.Discussion: This study reinforces previous findings in OftACD, such as older age of onset, and the importance of antibiotics, contrasting with the progressively lower prevalence of excipients. In addition, it helps raising awareness for the sensitization to beta-blockers, which is probably underestimated. Patch test preparations for the diagnosis of OftACD may require protocol optimization.

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Section: Introductionmentioning

confidence: 99%

“…9,10 Nevertheless, obtaining pure ingredients of topical ophthalmic medications and determining the appropriate concentration and vehicle for testing may be challenging in OftACD. 1,2,11 The main purpose of our study is to characterize patients with suspected OftACD in a population of Southern Europe.…”

Section: Introductionmentioning

confidence: 99%

A closer look at allergic contact dermatitis caused by topical ophthalmic medications

et al. 2022

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“… 14 In addition, periorbital skin in those with atopic dermatitis is vulnerable as a consequence of a defective barrier and is easily sensitized by contact irritants and other allergens. 24 Most biological agents can also cause immune dysregulation, which may exacerbate the disease. We propose that periorbital dermatitis related to panitumumab may share an overlapping pathophysiology with atopic eyelid dermatitis.…”

Section: Discussionmentioning

confidence: 99%

Panitumumab-Induced Periorbital Dermatitis: A Case Report

Pongbangpho,

Chanprapaph,

Iamsumang

2024

CCID

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Panitumumab is a recombinant, fully humanized immunoglobulin G 2 monoclonal antibody targeting the epidermal growth factor receptor (EGFR). It is approved for the first- and second-line treatment of advanced wild-type KRAS colorectal cancer. Although common cutaneous side effects include acneiform dermatitis, folliculitis, and xerosis, ocular toxicities have occasionally been reported. Herein, we report the case of an 81-year-old Thai female with chemorefractory advanced stage sigmoid colon cancer who developed isolated periorbital dermatitis following treatment with panitumumab plus modified FOLFOX6. The cutaneous adverse reaction recurred after subsequent infusions; however, it was alleviated by topical therapy. To our knowledge, panitumumab-induced periorbital dermatitis is exceptionally rare. To raise awareness of potential periocular cutaneous side effects in patients taking EGFR inhibitors, the published literature regarding periorbital dermatitis induced by these agents has also been reviewed in this article. Periorbital dermatitis should be considered as a potential cutaneous reaction following panitumumab administration, and should be promptly treated.

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“…[123][124][125][126] The likely explanation is that, whereas the anatomic and physiologic properties of the eyelid skin and conjunctivae are associated with a lower threshold to development of sensitization and allergic contact dermatitis, the low concentration of the allergens (usually 0.25% to 0.5%) in commercial products is insufficient to elicit an allergic reaction in the far thicker skin of the back. When contact allergy is strongly suspected, but patch tests are negative, the following alternative diagnostic methods have been suggested 127,128 : patch test on adhesive tape-stripped skin, 124,129 on skin 10 times pricked with a prick-test lancet, 130 or on scarified skin. 124 Other possibilities are pretreatment of the test area with 0.5% aqueous sodium lauryl sulfate solution for 24 hours, 131 enlarging the patch test area or to perform intradermal testing.…”

Section: False-negative Patch Test Reactionsmentioning

confidence: 99%