Atypical Diaper Dermatitis: Contact Allergy to Mercapto Compounds

Onken, Anna Theresa; Baumstark, Julia; Belloni, Benedetta; Ring, Johannes; Schnopp, Christina

doi:10.1111/j.1525-1470.2011.01640.x

Cited by 17 publications

(6 citation statements)

References 5 publications

(9 reference statements)

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“…In these cases the eczematous lesions are located on the outer buttocks and hips (named "Lucky Luke" contact dermatitis for the particular distribution of eczema recalling a cowboy's gun belt holster) or in the upper thighs corresponding to elastic borders of the diaper. [1][2][3][4][5][6] In our case, the clinical history and the initial presentation of the lesions in the perineal area and inguinal folds were suggestive for an irritant diaper dermatitis that had probably facilitated penetration of allergens and led to a contact allergy from rubber chemicals. Accordingly, patch testing was performed and was positive for both mercapto mix and MBT.…”

Section: Discussionmentioning

confidence: 75%

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Allergic contact dermatitis caused by the elastic borders of diapers

et al. 2019

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a case of allergic diaper dermatitis in a 1-year-old boy, caused by benzothiazoles (mercapto compounds). CASE REPORTA 1-year-old male infant presented with a 4-week-history of diaper rash, being otherwise healthy. Physical examination revealed oval, sharply demarcated erythematous and exudative plaques on his upper thighs. Some scattered erythematous papules were also observed on the pubic and perineal area (Figure 1). Over 1 week, the lesions gradually improved with oral cetirizine and topical zinc oxide. We performed patch tests with the AL test (Euromedical, Calolziocorte, Italy) on Scanpor tape (Norgesplaster, Vennesla, Norway) fixed on the back with Hypafix (BSN Medical, Hamburg, Germany) with an occlusion time of 2 days. The patient was tested with allergens potentially contained in the disposable diapers and diaper wipes in use, including thiuram mix 1% pet., colophonium 20% pet., mercapto mix 2% pet., fragrance mix I 8% pet., mercaptobenzothiazole (MBT) 2% pet., methylchloroisothiazolinone/ methylisothiazolinone (0.02% aq.), fragrance mix II 14% pet. and p-tertbutylphenol formaldehyde resin (PTBFR) 1% pet. Patch tests showed a + + reaction on day (D) 2 and D 4 to both mercapto mix and MBT. After switching diapers, the lesions totally disappeared without relapses. DISCUSSIONIrritant contact dermatitis with maceration and breakdown of the skin barrier caused by urine and feces is a common dermatological problem in the diapered pediatric population. Because damaged skin facilitates the penetration of potential allergens, chronic allergic contact dermatitis with a "swimsuit distribution" in diapered infants can ensue. 4 The most common potential allergens in diapers include botanical extracts, alpha-tocopherol, fragrances, propylene glycol, parabens, iodopropynyl butylcarbamate, and lanolin. 4Moreover, contact dermatitis from diapers due to rubber chemicals (mercaptobenzothiazole) or glues such as PTBFR has been reported. In these cases the eczematous lesions are located on the outer buttocks and hips (named "Lucky Luke" contact dermatitis for the particular distribution of eczema recalling a cowboy's gun belt holster) or in the upper thighs corresponding to elastic borders of the diaper. 1-6 In our case, the clinical history and the initial presentation of the lesions in the perineal area and inguinal folds were suggestive for an irritant diaper dermatitis that had probably facilitated penetration of allergens and led to a contact allergy from rubber chemicals. Accordingly, patch testing was performed and was positive for both mercapto mix and MBT. However, DI ALTOBRANDO ET AL. 71 it was impossible to trace back all the chemical products contained in the diapers in use. Thus, we cannot exclude that other possible rubber band materials played a role in the allergic reaction of our patient.A recent editorial has pointed to the lack of communication with, and cooperation from, the manufacturers of medical devices regarding the labeling of ingredients. 7 Although diapers cannot be considered medical devices ...

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Section: Discussionmentioning

confidence: 75%

“…Rubber contact dermatitis, although declining, still represents a widespread problem involving not only workers in the rubber industry but also the general population. [1][2][3] In this paper, we report a case of allergic diaper dermatitis in a 1-year-old boy, caused by benzothiazoles (mercapto compounds).…”

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confidence: 99%

Allergic contact dermatitis caused by the elastic borders of diapers

et al. 2019

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“…Allergic contact dermatitis as a cause of PD may be underrecognized. However, recent case reports 8,9,12,16,17 and data from large multicenter studies support that allergic PD may be underrecognized. 4,5 This is not surprising given the plethora of products associated with care for the modern baby, from the diaper, to diaper creams, wet wipes, topical medicaments, materials in toilet training seats, and toilet seat cleaners.…”

Section: Discussionmentioning

confidence: 89%

“…Multiple cases are reported of contact allergy with PPT reactions to mercapto mix, mercaptobenzothiazole, and ptertbutyl-phenol-formaldehyde resin (PTPFR) in the elastic bands of their diapers. 8,10,11 We were unable to ascertain from the diaper manufacturers what chemicals were used in the process of making elastic bands.…”

Section: Allergic Contact Dermatitis To Diaper Componentsmentioning

confidence: 99%

Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers

Yu¹,

Treat²,

Chaney³

et al. 2016

Dermatitis

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Botanical extracts, including members of the Compositae family, were the most commonly represented potential allergen in both diaper wipes and topical preparations. Other potential allergens identified with high frequency include α-tocopherol, fragrances, propylene glycol, parabens, iodopropynyl butylcarbamate, and lanolin. Frequent culprits such as formaldehyde releasers and methylchloroisothiazolinone/methylisothiazolinone were not prevalent in our analyzed products.

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“…Bei Fliesen-und Estrichlegern sowie bei Mechanikern und Bauarbeitern werden als Gründe das Tragen von Schutzhandschuhen aus (synthetischem) Gummi angeführt Das Tragen von Schutzhandschuhen scheint auch für die erhöhte Sensibilisierungsrate bei weiblichen Reinigungskräften verantwortlich zu sein [17]. Einzelbefunde deuten darauf hin, dass auch Windeln [18] und Bikini-Gummibänder [19] 2-MBT in Mengen enthalten können, die zu einer Sensibilisierung führen können.…”

Section: Stoffmonographie Für 2-mercaptobenzothiazol (2-mbt) Und Hbm-unclassified

Stoffmonographie für 2-Mercaptobenzothiazol (2-MBT) und HBM-Werte für 2-MBT im Urin von Erwachsenen und Kindern

Umweltbundesamtes¹

2015

Bundesgesundheitsbl.

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2-Mercaptobenzothiazole (2-MBT, CAS No. 149-30-4) is mainly used as a vulcanization accelerator in the production of rubber. Other applications are as a fungicide in paints and varnishs and for the external treatment of animals. Because of its manifold application in consumer products, for example in soothers, exposure of the general population to 2-MBT can't be excluded. For the purpose of a toxicological evaluation of a possible body burden, the German HBM-commission derived HBM-I values for 2-MBT in the urine of children and adults. The no observed adverse effect level of 94 mg/kg bw/d from a subchronic oral study with mice was used as the point of departure. After considering a total assessment factor of 350, a tolerable daily intake of 0.3 mg/kg bw/d was deduced for humans. Considering further the percentage of 2-MBT and its glucuronide excreted in urine together with the body weight proportional urine volume leads to an HBM-I value for 2-MBT of 4.5 mg/l urine for children and 7 mg/l urine for adults.

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Atypical Diaper Dermatitis: Contact Allergy to Mercapto Compounds

Cited by 17 publications

References 5 publications

Allergic contact dermatitis caused by the elastic borders of diapers

Allergic contact dermatitis caused by the elastic borders of diapers

Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers

Stoffmonographie für 2-Mercaptobenzothiazol (2-MBT) und HBM-Werte für 2-MBT im Urin von Erwachsenen und Kindern

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