Recognizing and Treating Toilet-Seat Contact Dermatitis in Children

Abstract

Toilet-seat contact dermatitis is a common condition around the world and is reemerging in the United States. It can be easily recognized and treated. However, few practitioners consider this diagnosis, which results in a delay in treatment and often exacerbation of the skin eruption. In the past, exposure to wooden toilet seats and associated varnish, lacquers, and paints led to the development of an allergic contact dermatitis on the buttocks and posterior thighs. In recent years, most public facilities have changed to plastic seats, resulting in a change in the clinical presentation of toilet-seat dermatitis. We present 5 cases of toilet-seat dermatitis in children from the United States and India and review the history, presentation, and clinical course of the disease. Our findings suggest that toilet-seat dermatitis is more common than previously recognized and should be considered in any child with a dermatitis that involves the buttocks and posterior thighs.

No small slam: increasing incidents of genitourinary injury from toilets and toilet seats

“…Topical injury was the second most common mechanism of non‐crush injures (9%). Several case reports describe incidents of contact dermatitis from unusual toilet seat products, such as exotic woods, polyurethane chemicals or even use of harsh toilet seat detergents . Of non‐crush injuries, five actual cases of contact dermatitis occurred after sitting on a toilet seat.…”

Persistent Allergic Contact Dermatitis to Plastic Toilet Seats

“…Delayed presentation is possible as the varnish on the toilet seat may take years to wear down, thus exposing the underlying base wood (2). Irritant reactions from harsh cleansers have also been implicated and occur in the same distribution (3). Only recently have plastic toilet seats been identified in causing allergic contact dermatitis (3).…”

“…Irritant reactions from harsh cleansers have also been implicated and occur in the same distribution (3). Only recently have plastic toilet seats been identified in causing allergic contact dermatitis (3). Identifying the specific component of plastic that a person is allergic to is often difficult to ascertain as the STEPS IN plastics manufacturing ARE quite convoluted and ingredient lists are not readily available.…”

“…It is interesting that the cases of toilet seat dermatitis recently published suggest that the use of paper seat covers was enough of a barrier to protect the skin from the offending allergen (3). In our patient’s case, total avoidance was necessary to achieve clearance.…”

Polyurethane Toilet Seat Contact Dermatitis

“…Although isocyanates may cause severe irritation of the skin, eye, and respiratory tract, polyurethane was thought not to be an irritant or a sensitizer (7), but reactions to polyurethane products have been reported recently. Goosens et al (2) reported 22 cases of allergic contact dermatitis to polyurethane components, with positive patch test results to isocyanates in 13 of them. It is estimated that reports of allergic contact dermatitis from polyurethanes will increase because their use has become more widespread.…”