A cream containing the chelator DTPA (diethylenetriaminepenta-acetic acid) can prevent contact allergic reactions to metals.
Chelating agents in protective barrier creams have often been used in the prevention of allergic contact dermatitis to nickel. In a pilot study, we demonstrated the preventive effect of 10% diethylenetriaminepentaacetic acid (DTPA) in an oil-in-water emulsion in nickel-sensitized patients. Now we reproduced these results in a randomized, double-blind study. Additionally, we investigated the efficacy of the barrier cream in other clinically relevant metal allergies. Individuals sensitized to various metals had a significant decrease in positive patch test reactions after pre-treatment with the DTPA-cream: 2.5% nickel sulfate (24/28 positive without pre-treatment versus 1/28 with pre-treatment; p<0.0001), 5% nickel sulfate (30/32 versus 15/32; p=0.0003), 1% cobalt chloride (19/20 versus 6/20; p=0.001) and 5% copper sulfate (13/14 versus 5/14; p=0.02). However, the cream had no protective effect with 1% palladium chloride (17/23 versus 16/23) and with 0.5% potassium dichromate (9/13 versus 7/13). We conclude that the DTPA-cream clearly abrogates positive patch test reactions in nickel-, cobalt- and copper-sensitized subjects and that it may therefore be helpful in the management of allergic contact dermatitis.
Wöhrl
S
S
FAZ - Floridsdorf Allergy Centre, Franz-Jonas-Platz 816, A-1210 Vienna, Austria.
Kriechbaumer
N
N
Hemmer
W
W
Focke
M
M
Brannath
W
W
Götz
M
M
Jarisch
R
R
D002614:Chelating Agents / Q000494:pharmacology*; D002857:Chromium / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D003300:Copper / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D019216:Metals, Heavy / Q000009:adverse effects*; D009532:Nickel / Q000009:adverse effects; D009824:Ointments; D010165:Palladium / Q000009:adverse effects; D010328:Patch Tests / Q000706:statistics & numerical data; D004369:Pentetic Acid / Q000494:pharmacology*; D012720:Severity of Illness Index; D012867:Skin / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
D002614:Chelating Agents; D019216:Metals, Heavy; D009824:Ointments; D002857:Chromium; D003035:Cobalt; C029938:nickel sulfate; D010165:Palladium; D003300:Copper; D004369:Pentetic Acid; D009532:Nickel