title: Cheilitis caused by contact allergy to cocamidopropyl betaine in '2-in-1 toothpaste and mouthwash'.
abstract: A 10-year-old girl presented with a 2-year history of severe cheilitis. Despite cessation of any lip-licking behaviour her symptoms continued to worsen, with only minimum relief from therapeutic measures. Patch testing proved strongly positive to cocamidopropyl betaine, which was noted to be present in the patient's '2-in-1 toothpaste and mouthwash'. Her cheilitis settled after avoidance of this product. Cocamidopropyl betaine, a surfactant, is a common allergen in hairdressers; however, this case highlights the importance of excluding a contact allergy to this product in patients with intractable cheilitis.
authors.affiliation: Skin and Cancer Foundation, Sydney, New South Wales, Australia.
authors.forename: Nita
authors.initials: N
authors.lastname: Agar
authors.forename: Susanne
authors.initials: S
authors.lastname: Freeman
mesh_terms: D001622:Betaine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D002613:Cheilitis / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010328:Patch Tests; D013501:Surface-Active Agents / Q000009:adverse effects*; D014100:Toothpastes / Q000009:adverse effects
chemical_list: D013501:Surface-Active Agents; D014100:Toothpastes; D001622:Betaine; C077055:cocamidopropyl betaine