High sensitization rate to emulsifiers in patients with chronic leg ulcers.
Emulsifiers are common constituents of most topical preparations. To study the sensitization rate in a population with frequent use of these agents, we selected 47 patients with chronic or recurrent (> 1 year) inflammatory skin disease (leg ulcers, contact dermatitis, atopic dermatitis, psoriasis) for patch testing with the following emulsifiers: Tween 40 (polyoxyethylene sorbitan monopalmitate). Tween 80 (polyoxyethylene sorbitan monooleate), Span 60 (sorbitan monostearate), Span 80 (sorbitan monooelate), Arlacel 83 (sorbitan sesquioleate), Atlas G 2162 (polyoxyethylene oxypropylene stearate), Atlas G 1441 (polyoxyethylene sorbitol lanolin derivative), triethanolamine, Lanette O (cetylstearyl alcohol), Lanette N. 12 patients had at least 1 positive reaction (25.5%) at 3 or 4 days. Among them, 10 had leg ulcers (43.4% of the leg ulcer group), and 2 had contact dermatitis (13.3% of the contact dermatitis group). No positive reaction was observed in the other patients. When the patients were tested with their own topical preparations or wound dressings, 6 of them, all with leg ulcers, had positive reactions. These results show a surprisingly high prevalence of sensitization to emulsifiers in patients with chronic leg ulcers, in contrast to patients with other inflammatory skin diseases.
Pasche-Koo
F
F
Department of Dermatology, University Hospital, Geneva, Switzerland.
Piletta
P A
PA
Hunziker
N
N
Hauser
C
C
D000287:Administration, Topical; D002908:Chronic Disease; D003872:Dermatitis / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D017449:Dermatitis, Allergic Contact / Q000209:etiology* / Q000276:immunology; D005079:Excipients / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007871:Leg Ulcer / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D010328:Patch Tests; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D012871:Skin Diseases / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D005079:Excipients