Occupational allergic contact dermatitis caused by morphine

Abstract

Natural alkaloids extracted from Papaver somniferum have long been known to cause allergic contact dermatitis, but the number of reported cases remains small. Herein, we describe a case of airborne occupational allergic contact dermatitis caused by morphine, with cross-reactions to chemically related congeners.

Occupational opiate contact dermatitis

“…Further studies are needed to examine cross‐sensitization. Moreover, it is crucial to establish that no other cross‐reactivity exists, in particular with synthetic products used for general anesthesia, as shown for fentanyl . Fortunately, our patients did not show cross‐sensitization to fentanyl, sufentanil, alfentanil, sufentanil, or tramadol, which can thus be used safely.…”

“…Occupational sensitizations to opiate derivatives have been described by several authors over the past century . We describe 2 cases of employees working in the same pharmaceutical plant who developed contact dermatitis caused by opiates they handled.…”

Morphine‐induced cutaneous adverse drug reaction following occupational diacetylmorphine contact dermatitis: A case report

“…Contact dermatitis and AGEP caused by diacetylmorphine and morphine have been reported before . Furthermore, the chemical similarities between morphine, diacetylmorphine and codeine are well known .…”

“…Contact dermatitis caused by diacetylmorphine (heroin) and by morphine have both been described before . In addition, a case of acute generalized exanthematous pustulosis (AGEP) as a reaction to morphine has previously been described .…”

Occupational allergic contact dermatitis caused by thebaine and oripavine

“…There seems to be no cross‐reactivity with morphine; however, patch testing of a larger group of patients is necessary to confirm this. Several authors (, ) have suggested testing morphine at 1% in aq., eth., or pet., and we followed this recommendation. However, testing at higher concentrations could be indicated.…”