Bilateral Symmetrical Contact Dermatitis on the Face and Outer Thighs From the Simultaneous Use of Two Mobile Phones

Esen Özkaya

Disclosures

Dermatitis. 2011;22(2):116-118. 

In This Article

Abstract and Introduction

Introduction

Précis Bilateral symmetrical lesions on the face and thigh from the use of two mobile phones simultaneously are reported as a novel pattern of mobile-phone dermatitis.

Discussion A 33-year-old Turkish nonatopic man presented with a 1-month history of pruritic symmetrical eczematous patches on both sides of the face (reaching from the preauricular area to lateral parts of the cheek) and on the anterolateral part of each thigh (Fig. 1A, 1B, and 1D). Clinical examination revealed further eczematous lesions on his abdomen corresponding to the contact sites of his belt buckle and the metal punch of his jean trousers (see Fig 1C). There was no history of similar lesions or metal allergy.

Figure 1.

A and B, Symmetrical eczematous patches on the right (A) and left (B) sides of the face, predominantly involving the preauricular areas. C, Periumbilical and abdominal eczematous patches corresponding to the contact sites of a belt buckle and the metal punch fastener of jean trousers. D, An eczematous patch on the anterolateral part of the right thigh. The left thigh was also involved owing to the patient's practice of keeping each of two phones in a different front trouser pocket.

The patient was a busy salesperson and was phoning for 3 to 4 hours a day. In the previous 6 months, he had frequently used two mobile phones simultaneously. Each mobile phone was kept in one of the front pockets of his trousers. Both of the mobile phones were of the same brand and had metal casings. The dimethylglyoxime test (Chemo Nickel Test, Chemotechnique Diagnostics, Vellinge, Sweden) revealed evidence of nickel release from the metal casings. The patient was unable to undergo patch testing because of the demands of his job. After he limited the use of the mobile phone and kept it in a belt pouch, the lesions cleared completely with topical corticosteroids within 10 days. He was further advised to use a mobile phone with a nonmetallic casing.

The simultaneous use of two mobile phones with metal casings, the symmetrical eczematous patches on both sides of the face and thigh (corresponding to the sites of contact with the metal phones), the positive dimethylglyoxime test result on the metal casings, and the improvement of the dermatitis with the avoidance of the phones indicated that the metal casings of the phones were probably causing a nickel-induced allergic contact dermatitis. As the patien's history did not reveal previous metal allergy, excessive use of the mobile phones might have caused sensitization, especially in the presence of coexisting factors such as friction, occlusion, and sweating.

Knowledge about the minimum exposure time required to sensitize and to elicit nickel contact dermatitis from the use of a mobile phone is lacking, as is a scientific definition of long-term skin exposure,[1] but the patient's use of mobile phones for 3 to 4 hours per day was highly excessive.

The number of reports of nickel-induced allergic contact dermatitis from the metallic exterior parts of mobile phones has increased during the last decade.[2–4] Dimethylglyoxime testing was found to be a valuable screening test for nickel release from the metallic parts of mobile phones.1 Recently, mobile phones have been covered by the European Union Nickel Directive.[5]

Unilateral involvement of the face (including the ear, preauricular area, and cheek, corresponding to the habit of usage) is characteristic of mobile-phone dermatitis.[2–4] Preauricular eczema has been further proposed as a diagnostic sign.[3] Recently, an unusual case with lesions on either side of the thigh from keeping the phone in one of the front trouser pockets was reported.[4]

This appears to be the first reported case of mobilephone contact dermatitis with symmetrical lesions on both sides of the face and thigh from using two mobile phones at the same time. Symmetrical eczema is mainly indicative of systemic allergic dermatitis; however (as in this case), it might also occur from simultaneous contact of the causative allergen with both sides of the body.

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