Mechanism of allergic contact dermatitis from propacetamol: sensitization to activated N,N-diethylglycine.
In order to confirm the mechanism of skin sensitization to propacetamol, a pro-drug of acetaminophen, 3 patients with allergic contact dermatitis from propacetamol were patch tested with N,N-diethylglycine phenyl ester, an activated form of N,N-diethylglycine. Positive patch tests were observed in all the patients at 10% in pet., while 20 control patients remained negative. This strongly suggests that propacetamol is acting as an activated form of N,N-diethylglycine, transferring this part of the molecule to nucleophilic residues of proteins. This also explains why reactions to acetaminophen have never been observed in patients sensitized to propacetamol.
Berl
V
V
Laboratoire de Dermatochimie associé au CNRS, Université Louis Pasteur, clinique Dermatologique, CHU, Strasbourg, France.
Barbaud
A
A
Lepoittevin
J P
JP
D000082:Acetaminophen / Q000009:adverse effects* / Q000031:analogs & derivatives*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D005260:Female; D006801:Humans; D009726:Nurses; D016273:Occupational Exposure / Q000009:adverse effects*; D010328:Patch Tests; D011355:Prodrugs / Q000009:adverse effects*
D018712:Analgesics, Non-Narcotic; D011355:Prodrugs; D000082:Acetaminophen; C063776:propacetamol