Multifocal Contact Dermatitis to Nitroderm TTS 5 with Extensive Postinflammatory Hypermelanosis

Harari, Z.; Sommer, Ilan; Knobel, B

doi:10.1159/000249190

Cited by 29 publications

(14 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be noted that I study recorded skin lesions in up to 75% of the patients (18). However, in general, other studies note this reaction infrequently (17,(19)(20)(21)(22). Unfortunately, patch testing was not performed to confirm whether the nitrate or a component of the patch was the cause of the dermatitis.…”

Section: Adverse Reactionsmentioning

confidence: 90%

“…Regardless, side-effects commonly associated with use were present, including headache, dizziness, and nausea. Contact dermatitis from TIS nitroglycerin, confirmed with patch tests, has been demonstrated in rare instances (14,(19)(20)(21)(22). Generally, the reactions occurred after 1-5 months of daily use.…”

Section: Adverse Reactionsmentioning

confidence: 98%

“…However, sublingual nitroglycerin and oral isosorbide dinitrate did not initiate reactions. Harari et al (21) reported an individual who developed extensive post-inflammatory hypermelanosis at the former sites of patch application 2 weeks after cessation of use. 8 months after discontinuation, separate patch tests with Nitroderm TTS-5, nitroglycerin in pet.…”

Section: Adverse Reactionsmentioning

confidence: 99%

“…and placebo device gave the same dermatological reaction. Harari et al (21) has previously studied Nitroderm TTS-5 over 3 years in 3273 patients, in whom no cutaneous reactions were observed (21). After cessation, individuals were patch tested and again no adverse dermatological reactions were recorded.…”

Section: Adverse Reactionsmentioning

confidence: 99%

See 3 more Smart Citations

A review of contact dermatitis associated with transdermal therapeutic systems

Holdiness

1989

Contact Dermatitis

View full text Add to dashboard Cite

The literature is reviewed for contact dermatitis associated with transdermal therapeutic systems. Clonidine, nitroglycerin, scopolamine, estradiol and testosterone are utilized in such applications, and fentanyl is under investigation. Most cutaneous reactions are limited to localized dermatitis; however, generalized systemic effects may occur. Investigators are reporting skin-related side-effects in up to 50% of patients using transdermal clonidine; however, with the other agents, this is demonstrated much less frequently. Reactivation of the dermatitis via oral medication, following sensitization to the patch, is noted in rare instances.Key words: transdermal therapeutic systems; contact dermatitis; adverse cutaneous reactions; donidine; nitroglycerin; scopolamine; estradiol; testosterone; fentanyl. Accepted fur publication 20 August 1988Transdermal therapeutic systems (TTS) have made possible effective "rate-controlled" transcutaneous administration of certain drugs. A number of other advantages include elimination of gastrointestional absorption, reduced total dosage, less expense than intramuscular or intravenous administration where applicable, avoidance of "first-pass" inactivation by the liver, use of agents with a narrow therapeutic index, and improved compliance with decreased administration cycle. Although these devices have proven quite useful, they are not without side-effects. One limitation is that of contact dermatitis, which in some instances necessitates discontinuation of the patch. It is the intention of this article to review the local and systemic side-effects of these systems.5 TTS are commercially available, which contain the compounds clonidine, nitroglycerin, scopolamine, estradiol, and testosterone; fentanyl is currently under investigation. Each consists basically of 4 membranes, as demonstrated in Fig. 1. The reservoir is surrounded by an occlusive backing membrane, which prevents the outward diffusion of the drug. A control microporous membrane allows diffusion of the medication at a constant controlled rate into the skin, with an adhesive for attachment to the surface. The approximate thickness of the 4 membranes is 0.2 mm. Adverse ReactionsClonidine is a centrally acting alpha-agonist used primarily as an antihypertensive agent. Standard predictive tests in guinea pigs indicate that it is not a contact allergen, as confirmed by clinical trials with the oral form (1). However, when the transdermal patch became available, a larger than expected proportion of users became sensitized. The most commonly reported side-effects of dry mouth and drowsiness were generally decreased with transdermal therapy (2, 3). Rebound hypertension with the patch has only rarely been reported (4, 5).

show abstract

Section: Adverse Reactionsmentioning

confidence: 90%

Section: Adverse Reactionsmentioning

confidence: 98%

Section: Adverse Reactionsmentioning

confidence: 99%

Section: Adverse Reactionsmentioning

confidence: 99%

See 2 more Smart Citations

A review of contact dermatitis associated with transdermal therapeutic systems

Holdiness

1989

Contact Dermatitis

View full text Add to dashboard Cite

show abstract

“…If the reaction is severe, resolution may be complicated by persisting postinflammatory pigmentation (Harari et al 1987). This is a nonspecific reaction due to damaged melanocytes whose melanosomes are engulfed by melanophages and remain in the papillary dermis.…”

Section: Allergic Contact Sensitivitymentioning

confidence: 99%

Skin Sensitivity and Transdermal Drug Delivery

Carmichael¹

1994

Drug Safety

View full text Add to dashboard Cite

Transdermal devices are now marketed for the delivery of systemic medication through the skin. Advantages associated with transdermal drug delivery include avoidance of first-pass metabolism and improved patient compliance. Drugs currently available by this route include scopolamine (hyoscine), nitroglycerin (glyceryl trinitrate), estradiol, nicotine and clonidine. This novel development has brought in its wake a specific constellation of skin sensitivity problems, which vary widely in incidence between drugs. Varying the site of drug administration to minimise these reactions is important. Any eczematous reaction can be treated with a moderately potent topical steroid. Tolerance to oral challenge in those with topical sensitivity occurs, but caution is still advocated before proceeding to this step. The increasing use of transdermal drug delivery systems across many specialties means that problems of skin sensitivity are of growing relevance to the dermatologist, the hospital specialist and the primary care physician.

show abstract

Glycerintrinitrat [MAK Value Documentation in German language, 2006]

2012

The MAK‐Collection for Occupational Health and Safety

View full text Add to dashboard Cite

Veröffentlicht in der Reihe Gesundheitsschädliche Arbeitsstoffe , 40. Lieferung, Ausgabe 2006 Der Artikel enthält folgende Kapitel: Allgemeiner Wirkungscharakter Wirkungsmechanismus Toxikokinetik und Metabolismus Erfahrungen beim Menschen Einmalige Exposition Wiederholte Exposition Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Tierexperimentelle Befunde und In‐vitro‐Untersuchungen Akute Toxizität Subakute, subchronische und chronische Toxizität Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Bewertung

show abstract

Multifocal Contact Dermatitis to Nitroderm TTS 5 with Extensive Postinflammatory Hypermelanosis

Cited by 29 publications

References 4 publications

A review of contact dermatitis associated with transdermal therapeutic systems

A review of contact dermatitis associated with transdermal therapeutic systems

Skin Sensitivity and Transdermal Drug Delivery

Glycerintrinitrat [MAK Value Documentation in German language, 2006]

Contact Info

Product

Resources

About