Polyethylene glycol as marker for nitrofurazone allergy: 20 years of experience from Turkey

Özkaya, Esen; Kılıç, Sıla

doi:10.1111/cod.12931

Cited by 28 publications

(17 citation statements)

References 31 publications

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“…Positive reactions may not always be achieved despite the use of allergens at appropriate concentrations in patch testing, which is extremely important in the assessment of ACD [14]. Ozkaya and Kılıç reported that late positive reactions to nitrofurazone, in which the reactions started on D4 or later (D7) in more than one-third of patients [9]. Because our study did not have late reading (D7), patch test results may be negative.…”

Section: Discussionmentioning

confidence: 93%

“…Nitrofurazone sensitization has been known for many years. Studies reported in the literature generally show nitrofurazone susceptibility rates in patch test results with topical drugs in ACD suspected cases [8, 9]. There are not many studies reporting only nitrofurazone-related ACDs.…”

Section: Discussionmentioning

confidence: 99%

“…ACD that was confirmed by the patch test against nitrofurazone developed in 28 of these patients. The most common dissemination pattern was generalized dissemination, followed by localized dissemination [9]. Our study covers a period of 5 years and contains 58 cases of ACD caused by nitrofurazone.…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous reactions caused by nitrofurazone

Bilgili

Ozaydin-Yavuz

Yavuz

et al. 2019

pdia

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IntroductionAllergic contact dermatitis (ACD) is a form of dermatitis due to type 4 hypersensitivity reaction that occurs when the skin comes into contacts with the topical product. Topical nitrofurazone is a widely used antimicrobial drug in our country which is well known to cause ACD.AimIn this study, ACD cases with different clinical features attributed to the use of nitrofurazone were evaluated.Material and methodsPatients hospitalized in our clinic between 2013 and 2017 with ACD diagnosis due to nitrofurazone were evaluated. The patient age, gender, atopy histories, clinical features, dissemination of the lesions, treatment given were reviewed.ResultsIn a 5-year period, 58 cases were identified and their data were analysed. Twelve patients were female (21%), 46 patients were male (79%). Clinical presentations were dyshidrosiform (45%), excoriated papules and plaques (33%), combined (21%), and erythroderma in one patient. The dissemination was generalized in 34 patients, localized in 14 patients, and local spread in 10 patients. The mean hospitalization time was 7 ±3 days, and ranged from 3 to 18 days.ConclusionsThere may be widespread and severe ACD due to the use of nitrofurazone. Topical nitrofurazone should not be applied on damaged skin as sensitization may develop. Patients and physicians should be aware of the ACD risk associated with topical nitrofurazone, which is also commonly used as self-medication, physicians should take a detailed history of the drug use and products containing nitrofurazone should not be used in conditions where skin integrity is not intact, whenever possible.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Cutaneous reactions caused by nitrofurazone

Bilgili

Ozaydin-Yavuz

Yavuz

et al. 2019

pdia

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“…Controls were done in healthy volunteers resulting negative in all of them. Taking into account that there are studies that have reported delayed hypersensitivity reactions to PEGs [7], a patch test was performed with Betadine ® solution, GripaNait ® , Ziverel ® , polysorbate 80, and PEG 4000 10%, but it was negative in all products.…”

Section: Case Presentationmentioning

confidence: 99%

Immediate hypersensitivity to polyethylene glycols in unrelated products: when standardization in the nomenclature of the components of drugs, cosmetics, and food becomes necessary

Cerdà

Pacheco

Witek

et al. 2019

Allergy Asthma Clin Immunol

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Background Polyethylene glycols (PEGs) and their derivatives are non-ionic polymers of ethylene oxide commercially available with numerous synonyms, such as macrogol, oxyethylene polymer, and laureth-9. Although these polymers are usually safe, mild to life-threatening immediate-type hypersensitivity reactions have been reported. Nevertheless, awareness about their allergic potential is minimal due to the non-standardization of their nomenclature. Case presentation We present the case of a 29-years-old woman who developed several local and systemic type I hypersensitivity reactions including a severe anaphylactic reaction to different pharmacologic and cosmetic products whose excipients included PEG. Prick tests and basophil activation tests were performed to several pharmacological and cosmetic products, but only those containing PEGs and their derivatives were positive. The patient was diagnosed with immediate hypersensitivity IgE-mediated to PEGs and its derivatives. Conclusions Standardization of the terminology used to describe the presence of PEGs in products would help patients to identify them clearly and unequivocally and thus avoid the development of hypersensitivity reactions. It is also recommended studying PEG allergy in reactions to products containing PEGs, once allergy to the active ingredients has been excluded and in reactions to multiple unrelated drugs. Clinical study protocol number PI2018/29 (registered on 24 September 2018)

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“…Various derivatives similar to lanolin alcohols exist, some of which were identified as contact allergens, such as cetearyl isononanoate [216]. Low-molecular weight polyethylene glycol is widely used in Turkey and has been found to be linked with nitrofurazone sensitisation, but has also been relevant when used in minoxidil solutions, and antiherpetic and corticosteroid creams [217]. Alkyl glucosides are widely used in cosmetics and other products, including a foam wound dressing, which caused ACD in a 70-year-old Belgian female [218], and several wound care and operative products causing ACD in 2 US patients [219].…”

Section: Medicines (Active Principles and Excipients) And Cosmeticsmentioning

confidence: 99%

Contact Allergy—Emerging Allergens and Public Health Impact

Uter

Werfel

Lepoittevin

et al. 2020

IJERPH

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Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals “Contact Dermatitis” and “Dermatitis” were manually searched, covering the years 2018–2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N’-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just as we have with cosmetics at present (apart from full listing of fragrance substances) in Europe, must be put on the legislative agenda.

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Polyethylene glycol as marker for nitrofurazone allergy: 20 years of experience from Turkey

Cited by 28 publications

References 31 publications

Cutaneous reactions caused by nitrofurazone

Cutaneous reactions caused by nitrofurazone

Immediate hypersensitivity to polyethylene glycols in unrelated products: when standardization in the nomenclature of the components of drugs, cosmetics, and food becomes necessary

Contact Allergy—Emerging Allergens and Public Health Impact

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