“Slime”: A trending cause of isothiazolinone contact allergy in children

Abstract

K E Y W O R D S : case report, contact allergy, methylchloroisothiazolinone/methylisothiazolinone, methylisothiazolinone, paediatric, slime dermatitis Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) (eg, Kathon CG), and MI are widely available preservatives that are mainly used in cosmetic and household products. Following a worldwide increase in contact allergy to MCI/MI and MI, 1 regulatory measures have been implemented. Although a decrease in contact sensitization has been reported, MCI/MI and MI are still frequent causes of contact dermatitis, and unexpected sources of exposure may be encountered in clinical practice. 2 Herein, we report three children with allergic contact dermatitis caused by MCI/MI and/or MI following exposure to a homemade play material called "slime." CASE REPORTSA 9-year-old girl presented with hand dermatitis of 3 months' duration. Dermatological examination showed papules and vesicles involving the lateral aspects of the fingers and periunguium ( Figure 1A). She had no personal or family history of atopy. Previous treatment attempts with topical corticosteroids led to temporary improvement, but the lesions had recurred. A 12-year-old girl was referred to our clinic with hand dermatitis of 5 months' duration. Physical examination showed erythematous, scaly plaques on both palms ( Figure 2A).The patient's medical history was insignificant. Treatment with topical corticosteroids was of no benefit. A 10-year-old, otherwise healthy girl presented with hand eczema that had developed after contact with homemade slime. Physical examination showed mild erythema with desquamation on the sides of the fingers ( Figure 3A). The patient claimed that the initial vesicular eruption has resolved shortly after she had stopped coming into contact with slime.The patients were patch tested with the European baseline series by the use of IQ Ultra Chambers obtained from Chemotechnique Diagnostics (Vellinge, Sweden). Reading of test results was performed on day (D) 2 and D3, according to ESCD guidelines. 3 The patch test results were as follows: In case 1, there was a + reaction to MCI/MI 0.02% aq. on D2, and there was a ++ reaction to MCI/MI 0.02% aq. on D3 ( Figure 1B). In case 2, there were + reactions to MCI/MI 0.02% aq. and to MI 0.2% aq. on D2, and ++ reactions to MCI/MI 0.02% aq. and to MI 0.2% aq. on D3 ( Figure 2B). In case 3, there was a ?+ reaction to MCI/MI 0.02% aq. on D2, and there was a + reaction to MCI/MI 0.02% aq. on D3 ( Figure 3B).A detailed repeat history showed contact with a homemade play material called "slime" in all three patients before the onset of symptoms.The cosmetic and household products added to the slime mixture were brought in by each patient, and detailed inspection of the labels and material safety data sheets confirmed the presence of MCI and MI in the following products: case 1-dishwashing liquid ( Figure S1A); case 2-Polyvinyl acetate glue (Figure S1B); and case 3-liquid soap ( Figure S1C). DISCUSSIONAlthough MCI/MI contact sensitization and MI contact s...

Contact Allergy—Emerging Allergens and Public Health Impact

“…Children have repeatedly been found to become sensitised to isothiazolinones (or occasionally other preservatives) when producing "home-made" playdough ("slime") or using commercial products containing these preservatives [118][119][120][121][122]. Misuse of a glitter glue sold on a market as "artistic material" as carnival make-up had resulted in papular face ACD [123].…”

Dermatite de contato à metilisotiazolinona – estamos atentos a essa epidemia?

“…Deve ser considerado como importante diagnóstico diferencial em eczema de mãos na infância. Normalmente, o quadro típico mostra hiperemia e descamação na ponta dos dedos 13 , porém formas mais graves de eczema podem ocorrer 14,15 .…”

Proinflammatory and regulatory mechanisms in allergic contact dermatitis caused by methylchloroisothiazolinone and methylisothiazolinone

“…Among these, allergens are heterocyclic organic compounds derived from isothiazolinone, methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI), which have bactericidal, fungicidal and algicidal properties and are therefore used as preservatives in cosmetics, industrial chemicals and consumer products 5,6 . Since the 1980s, there has been a marked increase in ACD cases caused by this substance, currently including children using school glue and slimes products 7‐10 …”