Back issues No.4 - 2009 / Original Study  

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Ichthyosiform Irritant Contact Dermatitis Caused by Antiseptics for Personal Hygiene
Yi-Pei Lee, Julia Yu-Yun Lee
Dermatol Sinica 27: 218-226,2009

Background: Antiseptics are commonly used for personal hygiene in Taiwan. We have previously
reported a series of ichthyosiform irritant contact dermatitis induced by cetrimide-containing
Objectives: To report a new series of antiseptics-induced ichthyosiform irritant contact dermatitis
and bring attention to the potential irritation effects of antiseptics.
Methods: We reviewed the clinicopathologic features of cases of cetrimide dermatitis, Savlon
dermatitis or ichthyosiform irritant contact dermatitis diagnosed in our department (October
1993-August 2008). Cases with characteristic ichthyosiform, scarlet to dusky red or chemical
burn-like skin lesions, primarily affecting the flexures and/or genital areas, and relevant exposure
histories were included.
Results: There were 35 patients (14 men and 21 women), aged from 3 to 79 years (mean 45
years). Most patients were seen in summer with a recognizable underlying pruritic dermatosis,
and had used commercial products containing cetrimide. The exposure time was from 4 days to
2 months (mean 3.4 weeks). The great majority (80%) had moderate or severe skin lesions characterized
by scarlet to dusky red or brownish lesions with a collodion membrane-like surface,
and showed a preferential involvement of the flexural and genital areas, especially the groin and
axilla where the lesions often manifested centrifugal rings. In no case was antiseptics-related dermatitis
suspected by the clinicians or the patients. Skin biopsy was performed in 5 patients; all
revealed changes consistent with cetrimide ichthyosiform irritant contact dermatitis.
Conclusions: Our study showed that self-application of cetrimide-containing antiseptics is still
an important cause of irritant contact dermatitis in southern Taiwan. This dermatitis should be
differentiated from ichthyosis, tinea circinata, erythema annulare centrifugum, and nutritional
deficiency diseases. Recognition of the clinical characteristics can prompt clinicians to inquire
about exposure to antiseptics and facilitate correct diagnosis.

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