Allergic contact dermatitis and conjunctivitis from epinephrine

Abstract

A patient with chronic open-angle glaucoma was suspected of having allergic dermatitis and conjunctivitis to epinephrine. He was tested with epinephrine and other active substances, the preservatives and antioxidants usually used in the preparation of eye drops. He was also tested with other possible contactants with which he had had contact. The patient showed positive allergic patch test reactions to the chloride solution of epinephrine. The patient showed an unexpected positive reaction when tested with di-isopropyl fluorophosphate (DFP). The importance of routine patch testing in ophthalmic practice to detect sensitizers in cases of contact allergy is stressed.

Contact dermatitis from dipivefrine with possible cross‐reaction to epinephrine

“…A wide variety of topical ophthalmics are contact sensitizers (1,2), including epinephrine hydrochloride (3)(4)(5). The development of dipivalyl epinephrine (dipivefrine), synthesised by the addition of 2 pivalic acid groups to epinephrine, results in a more lipophilic compound with greater penetration of the corneal layer and a lower incidence of side-effects than epinephrine, but with similar mydriatic effect on glaucoma (6,7).…”