Topical treatments in atopic dermatitis may lead to contact dermatitis

640 children with atopic dermatitis (AD) were patch tested with 7 agents of common topical treatment: chlorhexidine, hexamidine, budesonide, tixocortol pivalate, bufexamac, sodium fusidate and with the current emollient used by the child.

41 positive patch tests were found in 6% of patients.

Allergens were:

- emollients (47%)
- chlorhexidine (42%)
- hexamidine (7.5%)
- tixocortol pivalate and bufexamac (2.5% each)

Risk factors associated with sensitization to AD treatment were:

- AD severity
- AD onset before the age of 6 months
- IgE-mediated sensitization

The authors concluded that topical treatments for AD are associated with cutaneous sensitization. Antiseptics and emollients represent the most frequent sensitizers.



Atopic Dermatitis Treatment - Illustrated (click to enlarge the image).

References:

Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Mailhol C, Lauwers-Cances V, Rancé F, Paul C, Giordano-Labadie F. Allergy. 2009 Jan 29.

Image source: Moisturizer, White Petrolatum (vaseline), Wikipedia, GNU Free Documentation License.