A cream containing the chelator DTPA (diethylenetriaminepenta‐acetic acid) can prevent contact allergic reactions to metals

Abstract

Chelating agents in protective barrier creams have often been used in the prevention of allergic contact dermatitis to nickel. In a pilot study, we demonstrated the preventive effect of 10% diethylenetriaminepentaacetic acid (DTPA) in an oil-in-water emulsion in nickel-sensitized patients. Now we reproduced these results in a randomized, double-blind study. Additionally, we investigated the efficacy of the barrier cream in other clinically relevant metal allergies. Individuals sensitized to various metals had a significant decrease in positive patch test reactions after pre-treatment with the DTPA-cream: 2.5% nickel sulfate (24/28 positive without pre-treatment versus 1/28 with pre-treatment; p<0.0001), 5% nickel sulfate (30/32 versus 15/32; p=0.0003), 1% cobalt chloride (19/20 versus 6/20; p=0.001) and 5% copper sulfate (13/14 versus 5/14; p=0.02). However, the cream had no protective effect with 1% palladium chloride (17/23 versus 16/23) and with 0.5% potassium dichromate (9/13 versus 7/13). We conclude that the DTPA-cream clearly abrogates positive patch test reactions in nickel-, cobalt- and copper-sensitized subjects and that it may therefore be helpful in the management of allergic contact dermatitis.

WHO core prescribing indicators in patients with allergic contact dermatitis in a coastal town of South India

“…22 The most utilized binding agent is ethylene diamine tetraacetic acid (ETDA), which can be included at a 15% concentration in a cream in association with topical steroids. 23 In our study, average number of drugs per prescription is 6.8 which was found to be higher compared to a previous study done by Narwane et al, which should be decreased as use of polypharmacy is associated with so many problems like more drug interactions, more adverse effects, decrease in patient compliance, increased incidence of drug resistance and finally increased economic burden on the patients. 24 In our study, percentage of drugs prescribed by generic names and percentage of drugs from NLEM is much more compared to similar studies done by Anuj et al and Prasad et al which indicates a good trend of prescribing.…”

Nickel Toxicity and Carcinogenesis

“…Diethylenetriaminepentaacetic acid (DTPA) has been used successfully in patients to prevent allergic contact dermatitis caused by nickel, cobalt, or copper [59]. Numerous other chelators were tested for their effi cacy in removing nickel from the body, but only in animals; no defi nitive relationship between their structure and effectiveness was found [60,61].…”

Effectiveness of Barrier Creams against Irritant Contact Dermatitis

“…We identified 39 controlled trials (table 1) investigating the effect of BCs against skin irritants in a total of 929 volunteers (172 men, 279 women and 481 unspecified subjects) with healthy skin (n = 28), hand dermatitis (n = 1), skin sensitized to a specific allergen (n = 4) and 1 study on latex glove allergens [6,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52]. From these 39 papers, studies on excised skin [18,24,40,41,43,46] have been discarded, and only trials on subjects with healthy and non-sensitized skin were retained, reducing the list to 27 papers detailed in table 1.…”