Dermatitis Due to Aminoazotoluene

Abstract

Recently we have encountered, quite independently, three cases of contact dermatitis due to the yellow aniline dye aminoazotoluene. This dye, which is readily soluble in fats and waxes, is a constituent in the red and green semi-solid inks used in a popular ball-pointed pen. It is also used in certain popular shoe polishes. We have been unable to trace any previous reference to cases of dermatitis caused by exposure to aminoazotoluene. In view of these findings patch tests were done using various colours of semi-solid ink of the same make. It was found that, while the red and green inks gave a positive result in 24 hours, there was no reaction to the blue and black inks. The manufacturers of this pen kindly supplied the information that the only substance common to the red and green inks, and not used in any other of their inks, was the yellow dye-aminoazotoluene. A further controlled patch test, using 0.01% aminozatoluene in yellow soft paraffin, gave a positive reaction after 24 hours' contact.From these results it appeared that the patient's eruption was due to skin sensitization to aminoazotoluene. The dermatitis healed within four weeks of ceasing to use the red-ink pen, and has not reappeared.Case 2 A clerk aged 24 stated that she had suffered fromn a rash on her hands for five weeks, and was advised by her doctor to stay off work. Under his care the rash disappeared in two weeks, but returned on the evening of her first day back at work. She attended hospital four days later.On examination she was found to have a dry papulovesicular eruption along the ulnar border of the right hand and little finger, and on the medial aspect of the tips of her third and fourth fingers. The skin around the left eye showed slight oedema and fine superficial scaling. The clinical picture suggested a contact dermatitis of occupational origin.It was learnt that she was in contact with green semi-solid ink and carbon paper during her work, and before the second attack had accidentally smudged some green ink on her right upper eyelid. Whilst convalescing from the first attack at home she had used without mishap a similar ballpointed pen containing blue ink. She had used a green-ink pen for six weeks before the initial skin eruption developed.Patch tests to blue semi-solid ink and carbon paper were negative after 48 Case 3 A lady clerk aged 52 had suffered from an itching eruption of the anterior aspect of the right wrist for over a year. A few weeks before attending hospital it had spread up the forearm and also appeared on the eyelids. She had used a red-and-blue ball-pointed pen for about two years, and her work involved contact with accounts written in these same inks.Patch tests read after 24 hours showed she, too, was sensitive to the red and green but not to the blue semi-solid ink. Subsequently a positive reaction was obtained after 24 hours' contact with 0.01 % aminoazotoluene in yellow soft paraffin. This eruption cleared up 10 days after she stopped using the red ink, and had not recurred eight months later.

Allergenic and microbiological hazards caused by skin markings during medical procedures?

“…Current data analysis of the IVDK group shows that, despite their frequent use, contact allergies to skin markers are rare. This is consistent with the published literature, which only includes isolated cases of contact allergies to medical skin markers [ 1,2,[9][10][11][12] and nonmedical text markers (offi ce supply) [3][4][5][6][7][8][13][14][15][16][17] .…”

“…In 149 of these 453 patients (32.9 %), the patients' own materials were tested; (marker) pens were tested in three patients (total of eight patch tests; 0.0047 % of the entire collective) and were negative in each case. A PubMed literature search from 1953 to 2/2016 yielded 21 cases of allergic contact dermatitis caused by skin markers [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] , with different substances in the various products identifi ed as triggers (Table 1 ). These publications were case reports and not Abbr.…”