title: [Allergic contact eczema from shellac and 1,3-butylene glycol in an eyeliner].
abstract: BACKGROUND
  The diagnostic approach to eyelid eczema is often a great problem in daily practice.
  
  
  METHODS
  A 16-year old girl developed recurrent severe pruritic edema of the eyelids, followed by redness and scaling. Various cosmetics particularly an eyeliner were considered as possible causes. Patch testing was performed with the standard series, some supplemental series and all ingredients of the eyeliner.
  
  
  RESULTS
  The eyeliner produced a papular reaction after 2 days of open application, confirming a high degree of contact sensitization. The patient reacted with a 3+ reaction to the ingredients shellac (20% in ethanol) and 1,3-butylene glycol (2% in water). All remaining materials failed to produce a reaction.
  
  
  CONCLUSIONS
  Careful allergologic investigations are necessary in cases of edema and/or eczema of the eyelids; the cosmetics used by the patients are of utmost importance. The causative allergen may not be present in the usual patch test series and can only be identified by testing all ingredients. Shellac is now widely used in cosmetics and is increasingly identified as a contact allergen in eye make up.
authors.affiliation: Hautklinik, Klinikum Dortmund.
authors.forename: Alexander
authors.initials: A
authors.lastname: Magerl
authors.forename: Claudia
authors.initials: C
authors.lastname: Pirker
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Frosch
mesh_terms: D000293:Adolescent; D002072:Butylene Glycols / Q000009:adverse effects*; D003358:Cosmetics / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D012116:Resins, Plant / Q000009:adverse effects*; D012882:Skin Tests
chemical_list: D002072:Butylene Glycols; D003358:Cosmetics; D012116:Resins, Plant; C028491:1,3-butylene glycol; C003934:shellac