title: Pustular psoriasis and the Kobner phenomenon caused by allergic contact dermatitis from zinc pyrithione-containing shampoo.
abstract: Zinc pyrithione is a shampoo ingredient that has been shown to be safe and effective for dandruff and scalp psoriasis. It is thought to decrease the cell turnover rate in hyperproliferative dermatoses such as psoriasis, and also has fungistatic and antimicrobial activity, although its exact mode of action is unknown. In psoriasis, external factors, such as trauma, infection and drugs, may provoke aggravated manifestations of psoriatic skin lesions. Rarely, irritant or allergic mechanisms are likely causes of psoriatic flare and Kobnerization. A patient had had stable psoriasis for 25 years and no any other skin disease. Within 20 days, she developed an aggravated scaly erythematous patch on the scalp, where a shampoo had been applied, and simultaneously developed pustular psoriasis on both forearms. Patch testing showed a relevant sensitization to zinc pyrithione, and we observed symptomatic aggravation by provocation testing with zinc pyrithione shampoo. We report a rare case of psoriasis aggravated by the induction of allergic contact dermatitis from zinc pyrithione after using antidandruff shampoo.
authors.affiliation: Department of Dermatology, College of Medicine, Pusan National University, Busan, Korea.
authors.forename: Ju-Hyun
authors.initials: JH
authors.lastname: Jo
authors.forename: Ho-Sun
authors.initials: HS
authors.lastname: Jang
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Ko
authors.forename: Moon-Bum
authors.initials: MB
authors.lastname: Kim
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Oh
authors.forename: Yoo-Wook
authors.initials: YW
authors.lastname: Kwon
authors.forename: Kyung-Sool
authors.initials: KS
authors.lastname: Kwon
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D017449:Dermatitis, Allergic Contact / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006203:Hair Preparations / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011565:Psoriasis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D011725:Pyridines / Q000009:adverse effects*; D012307:Risk Factors; D012536:Scalp Dermatoses / Q000139:chemically induced* / Q000188:drug therapy; D017967:Zinc Compounds / Q000009:adverse effects*
chemical_list: D006203:Hair Preparations; D007166:Immunosuppressive Agents; D011725:Pyridines; D017967:Zinc Compounds; D016572:Cyclosporine