Severe vulvovaginal allergic contact dermatitis due to clotrimazole contained in multiple topical products

Corazza, Monica; Scuderi, Valeria; Toni, Giulia; Forconi, Riccardo; Zedde, Pierantonia; Borghi, Alessandro

doi:10.1111/cod.13385

Cited by 3 publications

(10 citation statements)

References 9 publications

(9 reference statements)

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“…In fact, the frequency of positive patch tests reactions to TAFs is strongly influenced by local prescribing habits, availability in the country, and also by the drug concentration on topical formulations. 1 Contact allergy to TAFs has been mainly reported by case reports or small case series of individual antifungals, 2,3,9 and there is a lack of information regarding the prevalence of TAF contact allergy. had the highest number of positive and doubtful reactions, with no reactions to other TAFs.…”

Section: Discussionmentioning

confidence: 99%

“…Allergic contact dermatitis has been reported as a side effect of these medications, although most evidence has come from small case series. [1][2][3][4] The aim of this study was to investigate the frequency and associated factors of contact allergy to TAFs.…”

Section: Introductionmentioning

confidence: 99%

“…Topical antifungals (TAFs) are commonly used in the treatment of superficial dermatophyte and yeast infections of the skin, nails, and hair. Allergic contact dermatitis has been reported as a side effect of these medications, although most evidence has come from small case series 1‐4 . The aim of this study was to investigate the frequency and associated factors of contact allergy to TAFs.…”

Section: Introductionmentioning

confidence: 99%

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Contact allergy to antifungals: Results of a 12‐year retrospective study

et al. 2022

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Background Contact allergy has been reported as a side effect of topical antifungals (TAFs), although most evidence has come from small case series. Objective To investigate the frequency and associated factors of contact allergy to TAFs. Methods We performed a retrospective analysis of the data of the Contact Allergy Unit of a University Dermatology Department between January 2009 and April 2021. From a cohort of 3788 patients tested in our unit, aimed testing was performed in 482 patients using TAFs from Chemotechnique Diagnostics (Vellinge, Sweden), allergEAZE, and, in some cases, commercial preparations ‘as is’. Results Contact allergy to antifungals was found in 27 patients (0.71% of consecutively tested patients and 5.6% of those who had aimed testing). Foot and leg eczema were the clinical presentation in 12 (44.4%) and 10 (37.0%) patients, respectively. Positive reactions were observed mostly with econazole nitrate 1% alcohol (51.9%), miconazole 1% alcohol (48.9%), tioconazole 28% solution (40.7%), and clotrimazole 5% pet. (18.5%). Fifteen patients (55.6%) had sensitization to more than one antifungal. Conclusions Contact allergy to antifungals was uncommon and occurred mostly associated with foot dermatitis. Most patients were sensitized to more than one chemical, particularly to azoles, which may limit future choices of TAF treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contact allergy to antifungals: Results of a 12‐year retrospective study

et al. 2022

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“…Imidazoles are the most frequently prescribed topical antifungal drugs. ACD caused by them is regarded as rare considering their high prescription rates [35]. Among the imidazoles, miconazole is the most frequent contact sensitizer [36].…”

Section: Medicamentsmentioning

confidence: 99%

“…A study showed that 1.8% of patients with positive patch test results were sensitized to clotrimazole [10]. Clotrimazole is a synthetic, broad-spectrum, phenethyl imidazole, and a cross-reaction between clotrimazole and miconazole was observed in some case reports [35,36].…”

Section: Medicamentsmentioning

confidence: 99%

Contact Dermatitis of the Vulva

et al. 2021

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The vulvar area is a common site of both irritative and allergic contact dermatitis due to the thin skin, easily traversable by irritant and allergic substances. The purpose of this review is to provide an overview of the most frequent allergens causing contact dermatitis in this particular site. A literature search was conducted via PubMed through May 2021. Relevant English language studies are included in this review. Fragrances, preservatives, botanical products, and topical medicaments were found to be the most commonly involved allergens. Contact dermatitis is a very common occurrence that should also be considered in patients with chronic vulvar or anogenital dermatitis who do not respond to appropriate treatments.

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