Generalized exfoliative dermatitis from ethylenediamine

Abstract

A patient with a history of allergic reaction to an antibiotic cream (Mycolog [mixture of nystatin, neomycin sulfate, gramicidin, and triamcinolone acetonide]) was treated with aminophylline. A generalized exfoliative dermatitis resulted. The reaction was attributable to ethylenediamine hydrochloride, which is a component of both agents. Recognition of the potential for systemic medications to induce similar reactions in patients who are allergic to related topical preparations is important when prescribing systemic agents.

Systemic allergic contact dermatitis due to ethylenediamine following administration of oral aminophylline

“…Cutaneous reactions have been reported following parenteral administration of aminophylline in individuals who have subsequently been shown to have positive patch test reactions to EDA but not theophylline. These reactions include exanthems, the baboon syndrome, 3 exfoliative dermatitis, 4 urticaria 5 and erythroderma 6 …”

Comparative pharmacokinetics of theophylline and aminophylline in man.

“…Ethylenediamine is an allergen suspected of causing contract dermatitis in nurses and other professionals handling aminophylline tablets and suppositories (White etal., 1978). Widespread dermatitis has also been described after intravenous administration of aminophylline in patients sensitized to ethylenediamine after using an antibiotic cream containing this compound as a stabilizer (Petrozzi & Shore, 1976;Provost & Jillson, 1967).…”

“…Some reports of allergic reactions toward ethylenediamine have appeared (White, Douglas & Main, 1978;Petrozzi & Shore, 1976). Because of this risk and the fact that pure theophylline is well absorbed from the gastrointestinal tract in spite of 0306-5251/81/030269-05 $01.00 its low solubility (Hendeles, Weinberger & Bigley, 1977), it is quite understandable that theophylline has been chosen for most modem sustained release preparations for long term treatment of asthma.…”