Benzyl Alcohol Allergy: Importance of Patch Testing with Personal Products

Endea J. Curry; Erin M. Warshaw

Disclosures

Dermatitis. 2005;16(4):203-208. 

In This Article

Case Report

A 57-year-old obese woman with a 10-year history of persistent pruritic dermatitis on her arms and legs presented to the University of Minnesota Occupational and Contact Dermatitis Clinic for patch testing. The dermatitis on her legs had been complicated by several bouts of cellulitis requiring oral and parenteral antibiotics. This presumed stasis dermatitis had also been treated with numerous topical antibiotic and corticosteroid preparations. At the time of patch testing, she was using fluocinonide 0.05% ointment, pimecrolimus 1% cream, and hydrocortisone 2.5% cream. She did not wear support stockings, and her 28-year career as a receptionist was thought to be unrelated to her dermatitis. Patch testing approximately 10 years previously had shown reactions to lanolin and neomycin, both of which the patient was successfully avoiding.

Patch testing was performed with an expanded standard series (64 antigens, with neomycin and lanolin removed) and with preservative, vehicle, corticosteroid, and cosmetic series. In addition, 20 personal products were also tested. The patch-test results are listed in Table 1 , and key reactions are shown in fig2. Based on these results as well as those from prior patch testing, the patient was diagnosed with allergic contact dermatitis to benzyl alcohol, class B corticosteroids, bacitracin, neomycin, lanolin, fragrance, and Euxyl K400 (Schülke & Mayr GmbH, Norderstedt, Germany). Because of doubtful reactions to mupirocin ointment and paraben mix, repeat patch testing with these antigens was recommended. The patient's dermatitis improved after discontinuing the use of benzyl alcohol–containing products and institution of hydrocortisone 2.5% ointment and petroleum jelly.

Key patch-test reactions.

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