A sudden flare‐up of a quiescent oral lichen planus: methylisothiazolinone as the prime suspect?

Abstract

A 61-year-old woman with a history of asymptomatic oral lichen planus, proven by mucosal biopsy 15 years previously, was referred to us with oral complaints that had occurred in September 2013, shortly after the placement of a new upper dental prosthesis (consisting of a metal frame made of a Vitallium ® alloy, containing cobalt, chromium, and molybdenum, and acrylate tooth material made of polymerized methyl methacrylate (PMMA); Fig. 1). The prosthesis was used by the patient without any fixative. After a few weeks, the wearing of the prosthesis had resulted in intraoral swelling, vesicles, and small, painful, aphthous ulcers, accompanied by a metallic taste and a dry mouth. Whenever she removed the prosthesis, the complaints settled after several hours, only to recur

Octylisothiazolinone, an additional cause of allergic contact dermatitis caused by leather: case series and potential implications for the study of cross-reactivity with methylisothiazolinone

“…This case is reminiscent of another patient with widespread dermatitis owing to the presence of MCI/MI in a preservative fluid added to the reservoir of a water bed mattress (20). Besides spilling of the fluid, with contamination of the mattress surface, penetration of MCI/MI through the mattress material might also have occurred in this particular case, taking into account the penetration capacity that has been highlighted for MCI and MI (21)(22)(23).…”

Contact allergy caused by methylisothiazolinone: the Belgian-French experience

“…detergents) being repeatedly in contact with the skin -hence behaving as "leave-on" products -contact dermatitis can easily be elicited and even induced [13], especially given the fact that the use concentrations of MI contained in some detergents may be rather high i.e. >100 ppm [14].…”

“…Moreover, we could demonstrate that, unlike (thick) nitrile gloves, natural rubber (latex) gloves do not prevent skin penetration by MI, hence explaining persistent hand dermatitis despite the use of so-called "protective" gloves [19]. Indeed, isothiazolinones such as MI, but also the related octylisothiazolinone (OIT), seem to exhibit the potential of penetrating various types of materials, an observation which should be taken into account when evaluating their sensitizing potential [14].…”

“…Of note, isothiazolinones can cause unusual clinical manifestations such as lupus-like skin lesions [29], urticaria [30], or even mimic cutaneous T-cell lymphoma [31]. Interestingly, MI can also act as a relevant sensitizer at the mucosal level, for example in the anogenital region, due to the use of sexual lubricants or wet wipes [11], and also at the oral mucosa [14]. a painter, consulted for a photo-aggravated dermatosis following airborne contact with MI-containing paint [11], an observation which was recently confirmed by French dermatologists (Dr. Brigitte Milpied-Homsi, personal communication, REVIDAL meeting, 13 January 2013, Paris).…”

Isothiazolinone derivatives and allergic contact dermatitis: a review and update

“…Besides MI, also BIT is often present in water-based paints. 25,51,54 Isothiazolinone derivatives: a review Several atypical clinical manifestations elicited by isothiazolinones have been described: systemic ACD from BIT after inhalation via airborne exposure 46,55 ; nummular eczema in a housepainter 56 ; lupus erythematosus-like eruptions 57 ; 'lymphomatoid' dermatitis 44,57,58 ; Kaposi-Juliusberg syndrome-like rash in a boy 37 and following exposure to paints 59 ; lichenoid eruptions; also a flare-up of a long-standing oral lichen planus, after the erroneous use of a dishwashing liquid for a dental prosthesis 60 ; and scalp lesions mimicking folliculitis decalvans due to a MI-containing hair gel. 61 A combination of urticarial and eczematous skin eruptions has been frequently observed, although Type I hypersensitivity, confirmed by positive prick tests, has never been reported.…”