Occupational contact dermatitis to propacetamol. Allergological and chemical investigations in two new cases.
OBJECTIVE
In 2 new cases of occupational contact dermatitis due to a recently described allergen (propacetamol), a prodrug which is a soluble diethylglycidyl ester of paracetamol, an allergological investigation was performed to elucidate the nature of the allergen involved in the propacetamol contact sensitivity.


METHODS
Two nurses with eczema of the hands and face had positive patch tests to Pro-Dafalgan. Every day the nurses prepared injections of Pro-Dafalgan (propacetamol dissolved in sodium citrate). The sensitization was due to propacetamol and not to the solvent. To elucidate which part of propacetamol was responsible for the sensitization, the 2 nurses were patch-tested with diethylamine, paracetamol (diluted in different vehicles) and some of their chemical analogues and potential impurities which were all negative.


CONCLUSIONS
Propacetamol induces airborne contact dermatitis with no evidence of sensitization to paracetamol or diethylglycine, possibly because of either the presence of unknown impurities and/or an antigenic structure related to the covalent bond of the prodrug.
Barbaud
A
A
Service de Dermatologie, H pital Fournier, Nancy, France. a.barbaud@chu-nancy.fr
Reichert-Penetrat
S
S
Tréchot
P
P
Cuny
J F
JF
Weber
M
M
Schmutz
J L
JL
D000082:Acetaminophen / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000737:chemistry / Q000276:immunology; D000328:Adult; D000485:Allergens / Q000276:immunology; D000700:Analgesics / Q000009:adverse effects* / Q000737:chemistry / Q000276:immunology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000737:chemistry / Q000276:immunology; D000941:Antigens / Q000276:immunology; D009783:Dermatitis, Occupational / Q000209:etiology*; D004048:Diethylamines / Q000009:adverse effects / Q000276:immunology; D004340:Drug Contamination; D004485:Eczema / Q000139:chemically induced; D005148:Facial Dermatoses / Q000139:chemically induced; D006229:Hand Dermatoses / Q000139:chemically induced; D006801:Humans; D007114:Immunization; D009726:Nurses; D010328:Patch Tests; D014677:Pharmaceutical Vehicles; D011355:Prodrugs / Q000009:adverse effects* / Q000737:chemistry
D000485:Allergens; D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000941:Antigens; D004048:Diethylamines; D014677:Pharmaceutical Vehicles; D011355:Prodrugs; D000082:Acetaminophen; C063776:propacetamol; C034281:diethylamine