title: Allergic contact dermatitis from methyldibromo glutaronitrile in a sanitary pad and review of Australian clinic data.
abstract: Methyldibromo glutaronitrile (MDBGN) has rarely been reported as an allergen in adhesives but is recognized as a common allergen in skin care products in Europe. It has been banned for use in leave-on products by the European Union. In this study, we present a case with an unusual source of this common allergen and review all cases of allergy to MDBGN from our clinics over a 12-year period. A 49-year-old nurse presented with dermatitis affecting the vulva caused by MDBGN present in her sanitary pad. All other cases of allergy to MDBGN in patients attending the occupational dermatology or contact dermatitis clinics at the Skin and Cancer Foundation, Victoria, between January 1993 and December 2004, were reviewed. Patch testing was positive to her sanitary pad, the adhesive and MDBGN, which were used as a biocide in the pad adhesive. Only 20 cases of allergy to MDBGN have been diagnosed in 2837 patients tested during this period (0.7%). To conclude, this study highlights the importance of considering allergic contact dermatitis in the differential diagnosis of vulval rashes and the emergence of MDBGN as an important sensitizer. However, our review suggests that MDBGN remains an infrequent cause of allergy in Australia.
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia. jwilliams@occderm.asn.au
authors.forename: Jason D
authors.initials: JD
authors.lastname: Williams
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Frowen
authors.forename: Rosemary L
authors.initials: RL
authors.lastname: Nixon
mesh_terms: D000485:Allergens / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D053566:Hygiene Products / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects*; D009790:Occupations; D010328:Patch Tests; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects*; D014739:Victoria / Q000453:epidemiology; D014844:Vulva / Q000473:pathology*
chemical_list: D000485:Allergens; D053566:Hygiene Products; D009570:Nitriles; D011310:Preservatives, Pharmaceutical; C039411:1,2-dibromo-2,4-dicyanobutane