Allergens Retained in Clothing

Susan Nedorost; Margaret Kessler; Thomas McCormick

Disclosures

Dermatitis. 2007;18(4):212-214. 

In This Article

Abstract and Introduction

Background: Some patients state compliance with avoidance of identified allergens, yet have persistent dermatitis in areas under tight-fitting clothing.
Objective: To analyze a series of such cases to identify allergens most likely retained in clothing.
Methods: Review of contact dermatitis clinic cases and identification of type and formula weight of allergens involved.
Results: High-formula-weight allergens and allergens present in medicament ointments are difficult to dissolve in laundry detergent and water and may be retained in clothing.
Conclusion: Retention of allergens in clothing, even after washing, may explain recalcitrant dermatitis in a patient who states compliance with avoidance of a seemingly relevant allergen. Dermatologists should consider the possibility of allergen retention in clothing whenever a patient has only partial clearing after at least 1 month of attempted compliance with avoidance of identified allergens. Purchase of new clothing may be required to clear allergic contact dermatitis in this situation.

IDENTIFICATION OF ALLERGENS by patch testing and subsequent patient avoidance of allergens for several weeks may entirely resolve allergic contact dermatitis. However, some patients have only partial clearance of dermatitis after avoiding allergens for 1 month or longer. If dermatitis persists in areas of tight-fitting clothing, retention of allergens in clothing should be considered.

Retention of allergens in shoes has been previously reported. Mercaptobenzothiazole is a rubber allergen in shoes and may persist in socks even after they have been washed or boiled in water.[1] Corticosteroids may be retained in shoe materials and cause persistent dermatitis even after the steroid-allergic patient discontinues application.[2]

With our contact dermatitis patients, retention of allergens in clothing is often due to topical medicaments. Dermatitis affects areas of tight-fitting clothing, such as the areas under hems, gloves, elastic, or brassieres.

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