Pustular allergic contact dermatitis caused by fragrances

Verma, Amit; Tancharoen, Chasari; Tam, Mei; Nixon, Rosemary

doi:10.1111/cod.12341

Cited by 22 publications

(18 citation statements)

References 9 publications

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“…One of these patients, as in the present case, was a hairdresser, and she also had facial lesions attributed to formaldehyde contact allergy; avoidance of cosmetics containing this preservative led to remission. A case of pustular contact dermatitis caused by fragrances (fragrance mix II, Evernia prunastri , citral, and tea tree [ Melaleuca alternifolia ] oil), attributed to an aftershave, was reported in 2015; also in this case, avoidance led to clinical remission …”

Section: Discussionsupporting

confidence: 78%

“…Our patient was shown to be sensitized to fragrances, notably limonene, and formaldehyde. Although the morphology of the patch test reactions was not pustular, as in the case report described by Verma, our patient did show a striking flare‐up of pustular skin lesions during the patch test week, supporting potential relevance of the positive patch test reactions. We believe that she did suffer from an actual pre‐existing rosacea that, unfortunately, became complicated by not only direct but also mainly airborne contact allergy to formaldehyde and fragrances, especially limonene.…”

Section: Discussioncontrasting

confidence: 46%

“…A case of pustular contact dermatitis caused by fragrances (fragrance mix II, Evernia prunastri, citral, and tea tree [Melaleuca alternifolia] oil), attributed to an aftershave, was reported in 2015; also in this case, avoidance led to clinical remission. 3 Our patient was shown to be sensitized to fragrances, notably limonene, and formaldehyde. Although the morphology of the patch test reactions was not pustular, as in the case report described by Verma, 3 our patient did show a striking flare-up of pustular skin lesions during the patch test week, supporting potential relevance of the positive patch test reactions.…”

Section: Discussionmentioning

confidence: 69%

“…Clinically, allergic contact dermatitis usually presents as eczema ("dermatitis"), although non-eczematous forms of contact allergy also exist, 6 including pustular contact dermatitis, the latter, among others, being related to fragrance contact allergy. 3 Moreover, pre-existing dermatoses such as acne vulgaris and psoriasis may become complicated by secondary contact allergy. Sometimes, the predominant morphology of such "complicated dermatosis" is that of the underlying condition.…”

Section: Discussionmentioning

confidence: 99%

“…

CASE REPORTA 50-year-old non-atopic female hairdresser began to suffer from erythematous and pustular dermatitis on the cheeks, forehead, and chin

…”

mentioning

confidence: 99%

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Contact allergy to fragrances and formaldehyde contributing to papulopustular rosacea

2019

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Allergic contact dermatitis caused by fragrances and formaldehyde is common, 1,2 but pustular dermatitis as a manifestation of contact allergy is rare. 3 We report a case of therapy-resistant rosacea for which (occupational) contact allergy to fragrances, and to a lesser extent formaldehyde, was identified as an aggravating factor. CASE REPORTA 50-year-old non-atopic female hairdresser began to suffer from erythematous and pustular dermatitis on the cheeks, forehead, and chin ( Figure 1). Having been diagnosed with papulopustular rosacea, she had been treated with topical metronidazole and ivermectin, and with systemic tetracyclines, without any relief. The patient herself had related episodic flare-ups of the dermatitis to her own cosmetics, but also to airborne exposure to cosmetics used at the hair salon. Therefore, she had strongly restricted her own use of these, and had been off work for 6 months, leading to significant amelioration, but not complete resolution. Besides a relapse of dermatitis, she mentioned the occurrence of migraine-like headache and general discomfort whenever she re-entered the hair salon, or whenever she came into contact with heavily scented customers.Because of these potential (and partially occupational) environmental factors contributing to her skin condition, she was referred to our department. No hand dermatitis was present, and nor had it been present in the past during any working activities, during which she regularly wore (nitrile) gloves. The facial dermatitis indeed suggested a diagnosis of papulopustular rosacea. However, atypical features, such as vesiculation, eczematization and itching, indicated that contact allergy might also be present. Therefore, patch tests were performed with the Belgian baseline series (based on the recently revised European baseline series), 4 and with cosmetic, fragrance, metals and hairdressing series, all from Chemotechnique Diagnostics (Vellinge, Sweden). All preparations were applied on Allergeaze patch test chambers (SmartPractice, Calgary, Canada), and occluded for 2 days with Fixomull stretch (BSN Medical, Hamburg, Germany). Readings were performed on day (D) 2 and D4 according to European Society of Contact Dermatitis guidelines. 5 On D4, formaldehyde 2% aq. gave a positive reaction (++), as did the weak releaser imidazolidinyl urea (?+) and the stronger releaser diazolidinyl urea (+). Moreover, positive reactions were observed to fragrances: fragrance mix II (+), Myroxylon pereirae resin (+), and, especially, limonene hydroperoxides 0.3% and 0.2% pet. (++) ( Figure S1), but not to linalool hydroperoxides 1% and 0.5% pet. Interestingly, during patch testing, the patient experienced a pronounced flare-up of pustular skin lesions on her cheeks and forehead ( Figure S2).As the patient had already discarded the majority of her formerly used cosmetic products, we could not verify any particular relevance related to the use of these personal care products, with the exception that most of them were scented. We asked her to verify her occupatio...

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

“…

CASE REPORTA 50-year-old non-atopic female hairdresser began to suffer from erythematous and pustular dermatitis on the cheeks, forehead, and chin

…”