Skin Reactions to Pimecrolimus Cream 1% in Patients Allergic to Propylene Glycol: A Double-Blind Randomized Study

Jf, Fowler; Fowler, Lynn M.; Jl, Douglas; Thorn, D; Parneix-Spake, Anne

doi:10.2310/6620.2007.06028

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…10,11 However, some authors believe the relevance of contact sensitization to PG to be overestimated. 12,13 Evaluating patch test results to PG can be challenging for clinicians, as weak positive reactions may be interpreted as irritant reactions and vice versa, 11 however weak late reactions, usually a day(D) 7 reading, may be relevant. 7,14 It is important for clinicians to patch test with a concentration of PG that is high enough to elicit a true positive patch test reaction, yet also minimize the irritant potential of the allergen.…”

Section: Introductionmentioning

confidence: 99%

Allergic contact dermatitis from propylene glycol: A case series from Australia

2023

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Background Propylene glycol (PG) is used in a variety of cosmetics, food and pharmaceuticals. PG is a known sensitizer but also irritating when patch tested (PT). Objectives The aims were to investigate the frequency of contact sensitization to PG and to identify cases of allergic contact dermatitis (ACD). Methods A retrospective study was performed on patients PT at the Skin Health Institute (SHI), Victoria, Australia to PG 5% pet. and PG 10% aq. between 1 January 2005 and 31 December 2020. Results In all, 6761 patients were PT to PG and 21 (0.31%) reacted. Of those 21 individuals, 9 (42.9%) had a relevant reaction. 75% of relevant positive reactions were in patients PT to PG 10% aq. The most common source of PG exposure was topical medicaments (77.8% of relevant reactions) and moisturizers, with the largest group being topical corticosteroids. Conclusion Contact sensitization to PG in the patch test population remains uncommon, although it is possible that testing with concentrations of 5%–10% PG did not identify all reactions. Topical corticosteroids were the most important cause. Patients with suspected contact dermatitis to topical corticosteroids should be PT to PG.

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Section: Introductionmentioning

confidence: 99%

Allergic contact dermatitis from propylene glycol: A case series from Australia

2023

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“…Contact dermatitis in reaction to propylene glycol in calcipotriene ointment and an ultrasonic gel [36,37,38,39], as well as in an antiviral cream (Zovirax®) [40], has been reported. Flares of contact dermatitis following the ingestion of foods containing propylene glycol have been noticed [30], and systemic contact dermatitis due to intravenous propylene glycol in diazepam (Valium®) in a patient sensitized to propylene glycol has been reported [41].…”

Section: Discussionmentioning

confidence: 99%

Contact Urticaria with Systemic Symptoms due to Hexylene Glycol in a Topical Corticosteroid: Case Report and Review of Hypersensitivity to Glycols

Spoerl

Scherer

Bircher³

2010

Dermatology

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We report a case of severe contact urticaria with systemic involvement resembling an anaphylactic reaction, following the application of a topical corticosteroid. This was caused by hexylene glycol, an excipient in the formulation. Glycols are widely used in cosmetics, foods and topical and systemic drugs. In particular, glycols are present in many topical drugs used by dermatologists. To our knowledge, this is the first case in the literature of a potentially life-threatening immediate-type reaction in the context of a contact urticaria syndrome due to hexylene glycol. The classification of contact urticaria syndrome and the allergenic potential of glycols are reviewed. Dermatologists should be aware of the contact urticaria syndrome and of the increasing use of glycols in topical drug formulation in order to identify possible adverse reactions.

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“…[34][35][36][37] It appears that most cases of contact allergy were related to pimecrolimus use, possibly due to the presence of cetyl alcohol, stearyl alcohol or polypropylene glycol, which are known to cause contact dermatitis. [34][35][36][37] It appears that most cases of contact allergy were related to pimecrolimus use, possibly due to the presence of cetyl alcohol, stearyl alcohol or polypropylene glycol, which are known to cause contact dermatitis.…”

Section: Tcis Contact Allergymentioning

confidence: 99%

“…Contact allergy has been anecdotally reported in association with TCI treatment. [34][35][36][37] It appears that most cases of contact allergy were related to pimecrolimus use, possibly due to the presence of cetyl alcohol, stearyl alcohol or polypropylene glycol, which are known to cause contact dermatitis. 36,38 However, the participants agreed in not considering contact allergy as differentiating issues between the two TCIs, because of the poor evidence available in the literature and the well-established safety profile of both compounds in clinical practice.…”

Section: Tcis Contact Allergymentioning

confidence: 99%

Position statement: topical calcineurin inhibitors in atopic dermatitis

Remitz

Pità

Mota

et al. 2018

Acad Dermatol Venereol

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Background Atopic dermatitis (AD) is a common inflammatory skin disease in both adults and children. Whilst topical calcineurin inhibitors (TCIs), tacrolimus ointment and pimecrolimus cream, have proven efficacy for the treatment of AD, it is important to involve experts to obtain their opinion on its optimal treatment. Objective Using a modified Delphi approach, this project aimed to generate consensus amongst experts on the use of TCIs in the treatment of AD, with a focus on the differentiation between tacrolimus and pimecrolimus. Methods Six expert dermatologists from different European countries participated in this project based on their experience with AD and its treatment, which was evaluated by literature analysis and expert opinion. Consensus amongst the experts was generated using a modified Delphi approach, consisting of three distinct phases, during which a web meeting (June 2017), two online rounds of blinded Delphi voting (July–September 2017) and a face‐to‐face meeting (November 2017) were conducted. The consensus statements concerned two main topics: (i) Background of AD; and (ii) TCIs in AD. Hot topics in the treatment of AD not supported by meta‐analysis, clinical trials or large observational studies were also discussed based on clinical experience. Results In total, 25 consensus statements were defined and validated: eight statements on the general background of AD and 17 statements on the use of TCIs in AD, including their mechanism of action and therapeutic indications in AD, efficacy in adult and paediatric AD patients, pharmacokinetics, incidence of adverse events and safety concerns. Hot topics on the use of TCIs for the treatment of AD included cream vs. ointment, dosages, TCIs contact allergy, burning sensation management, superinfection and vaccination concerns. Conclusion Topical calcineurin inhibitors are a suitable therapy for AD, and selection of the specific TCI should be based on factors which differentiate tacrolimus from pimecrolimus.

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Skin Reactions to Pimecrolimus Cream 1% in Patients Allergic to Propylene Glycol: A Double-Blind Randomized Study

Cited by 7 publications

References 15 publications

Allergic contact dermatitis from propylene glycol: A case series from Australia

Allergic contact dermatitis from propylene glycol: A case series from Australia

Contact Urticaria with Systemic Symptoms due to Hexylene Glycol in a Topical Corticosteroid: Case Report and Review of Hypersensitivity to Glycols

Position statement: topical calcineurin inhibitors in atopic dermatitis

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