Allergic contact connubial dermatitis caused by hair products

Abstract

Most cases reported are attributable to fragrances, cosmetics, or topical non-steroidal anti-inflammatory agents. [2][3][4][5] We report connubial dermatitis in a man caused by his wife's hair products. CASE REPORTA 49-year-old man, a locksmith with no significant prior medical history, presented with a 2-year history of recurrent pruritic eczema involving the left arm (Figure 1), left chest, and back. Initially, atopic dermatitis was suspected by the attending dermatologists. Repeated treatments with topical corticosteroids, oral corticosteroids and cyclosporin proved effective, but with immediate recurrence after cessation. The patient was referred to our immunoallergology clinic for patch testing, as contact allergy was suspected. Physical examination showed coarse, small erythematous papules coalescing into eczematous plaques involving the back, left chest, and flexor surface of the left forearm. The presentation was suggestive of contact dermatitis.Patch testing was performed with the European/Portuguese baseline series and a hairdressing series (Vila Nova de Gaia, Roxall Aristegui, Portugal). Allergens were applied on the back with Finn Chambers (Chemotechnique Diagnostics, Vellinge, Sweden) on Scanpor tape (Bastos Viegas, Penafiel, Portugal). Readings were performed on day (D) 2 and D3, according to ICDRG criteria, and showed strong positive reactions to p-phenylenediamine (PPD) 1% pet., methylisothiazolinone 0.2% aq., p-aminodiphenylamine 0.25% pet., o-nitro-PPD 1% pet., PPD dihydrochloride 0.5% pet., and diaminotoluene sulfate 1% pet. ( Figure S1).The patient denied dyeing his hair, having tattoos, or having contact with ink or textiles at work. However, his wife dyed her hair regularly with various products. The patient reported direct contact with his wife's hair, especially while sleeping at night, because she slept on his left side. Our recommendations included the use of PPD-free hair dye for his wife, additional avoidance of the other components identified above, and the use of topical corticosteroids as needed. In a reassessment 2 months later, the patient reported resolution of the lesions since his wife had been avoiding the culprit products and had cut her hair. DISCUSSIONThis clinical case shows that a unilateral pattern can be an important indicator of connubial contact dermatitis. In the present case, the patient's lesions were on the left side where his wife slept, leading to exposure to his allergens. We highlight the importance of enquiring about any products used not only by the patients but 186 FERREIRA ET AL. also by relatives, and of maintaining a high degree of suspicion for connubial dermatitis. The correct, early diagnosis is essential for adequate treatment, to avoid worsening of symptoms, and to avoid the use of drugs that are not effective or are even contraindicated in this clinical situation. Many cases are possibly over-looked or misdiagnosed, as had happened with our patient for 2 years. CONFLICTS OF INTERESTThe authors have no conflicts of interest to report. ORCIDCristia...

Paediatric phytophotodermatitis ‘by proxy’ from parental transfer of lime

“…2 Classically, this transfer is from one partner or spouse to another, but has also been reported from pets to owners and rarely from parent to child. [3][4][5] While allergic contact dermatitis 'by proxy' from parent to child has been reported, no cases of PPD 'by proxy' from parent to child have been reported. Thorough history-taking, including discussion of potential parental exposures, is important in the work-up of paediatric PPD.…”

“…Connubial contact dermatitis, also called dermatitis ‘by proxy’ or consort dermatitis, refers to dermatitis, typically allergic contact dermatitis, in which there is an inadvertent transfer of the causative allergen or phototoxin from one individual to another 2 . Classically, this transfer is from one partner or spouse to another, but has also been reported from pets to owners and rarely from parent to child 3‐5 . While allergic contact dermatitis ‘by proxy’ from parent to child has been reported, no cases of PPD ‘by proxy’ from parent to child have been reported.…”

Pet consort dermatitis from dog grooming products

“…Severe infantile facial dermatitis has been reported in infants who were allergic to fragrances used in their mothers' cosmetics . Recurrent eczema developed on the left arm, left side of chest, and back of a man who had regular contact with his wife's hair, frequently dyed with products containing p ‐phenylenediamine …”

Kontaktallergien – Neu aufkommende Allergene und Auswirkungen für das Gesundheitswesen

“…Nicht nur die Haare, auch die Augenbrauen oder der Bart können gefärbt werden, und die Färbemittel können in der jeweiligen Region ACD hervorrufen [259, 260]. Bisweilen ist hiervon nicht die Person, die das Haarfärbemittel verwendet, selbst betroffen, sondern ihr (Tanz-)Partner; dies wird als Partner- oder Consort-Dermatitis bezeichnet [261, 262]. Neben den häufigen Sensibilisatoren wie p-Phenylendiamin (PPD) [263] und Toluol-2,5-Diamin wird gelegentlich auch über „seltene“ Ursachen z.…”