Allergic contact dermatitis from azathioprine

A 51-year-old production mechanic for a pharmaceutical company complained of a dermatitis involving his hands. The onset of the eruption coincided with when he was placed on the production packing line for azathioprine tablets. Patch testing showed a positive allergic reaction only to azathioprine diluted in petrolatum. A pharmaceutical product such as azathioprine may need to be considered as a cause for allergic contact dermatitis in patients with a history of exposure during the manufacturing process.     

Allergic contact dermatitis from hydrocolloid dressings

A 4-month-old infant presented with aneurysm of patent ductus arteriosus (PDA) which was causing obstruction of the left main bronchus. The patient had elevated pulmonary vascular resistance (PVR) at 6.1 um2. The aneurysm was resected on cardiopulmonary bypass. The patient required phenoxybenzamine and prostacycline after the operation for elevated PVR. Postoperative progress was prolonged but 12 months after surgery the patient is well, growing normally without any respiratory symptoms.     

Allergic contact dermatitis from cobalt in animal feed

A 39-year-old woman with systemic lupus erythematosus suffered a prolonged neurological illness associated with very low levels of glucose in her cerebrospinal fluid (CSF). Six months later, and after numerous CSF investigations, Histoplasma capsulatum was cultured. To our knowledge, this is the first report of cerebral histoplasmosis in Australia in a patient who is not HIV positive.     

Allergic contact dermatitis from ethyl sebacata in haloprogin cream

A 13-year-old girl developed contact dermatitis to haloprogin (Halotex) cream. Patch tests incriminated ethyl sebacata, a solubilizer, as the allergen. To our knowledge, this is the second reported case of contact dermatitis attributable to this substance.     

Allergic and systemic contact dermatitis from Matricaria chamomilla tea

A screening programme was carried out among school-going children in Al-Ain, United Arab Emirates (UAE), to identify children with learning disorders. During the course of one academic year, 34 such children were identified. The cause was considered preventable in around half of the cases. In a third of cases with a genetic cause, prevention was possible with existing knowledge and practice.     

Allergic contact dermatitis to quinones in Paphiopedilum haynaldianum (Orchidaceae)

An eczematous eruption developed on the hands and forearms of a 68-year-old man after frequent contact with homebred specimens of the lady slipper Paphiopedilum haynaldianum. Patch tests with leaves, petals, and stems, as well as with two quinones isolated from the plant by thin-layer chromatography, gave strongly positive reactions. The results demonstrated that the recurrent skin lesions were the expression of an allergic contact dermatitis due to the quinoid constitutnets, which are the main contact allergens in this orchid species.     

Allergic and photoallergic dermatitis from diphenhydramine

A 52-year-old man developed contact and photoallergic dermatitis caused by diphenhydramine hydrochloride as well as contact dermatitis from paraphenylenediamine. The diphenhydramine photoallergy was elicited by long-wave ultraviolet light. The action spectrum differs from that noted in a recent report in which wavelengths shorter than 320 nm were responsible for eliciting diphenhydramine photoallergy. To the best of my knowledge, this is the third case of diphenhydramine photosensitivity reported in the English literature. The combination of both contact and photosensitivity to diphenhydramine has not previously been described.     

Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste

A patient had acute stomatitis and dermatitis due to a popular toothpaste containing cinnamon oil flavor. Cinnamon cassia oil is known as a topical sensitizer and was demonstrated to be the offending allergen. Cinnamic aldehyde and related chemicals are used widely, so that patients having cinnamon allergy may be exposed to many sources. There is difficulty in diagnosing allergic contact stomatitis.     

Erythema-multiforme-like contact dermatitis from budesonide

A three-fold greater incidence of chemical burn injuries in Jamaican hospitals, compared to burn centres in other industrial countries, underscores the problem of the use of common chemicals for assault weapons in this country. With the increased availability of guns for personal use, many Jamaicans learned the value of carrying household chemicals such as sulphuric acid from batteries or sodium hydroxide obtained from cleaning supplies. Chemicals carried in a container, such as one might carry mace, afforded a means of defence among the lower socioeconomic groups who could not afford handguns. This use of dangerous chemicals for defensive weapons has extended to the use of chemicals for assault. The pattern of chemical injury differs significantly from most reports in the literature in both prevalence and aetiology. This review was prepared to examine these injuries with a view to planning strategies for prevention.