title: Contact dermatitis with clostridiopeptidase A contained in Noruxol ointment.
abstract: Clostridiopeptidase A, also called collagenase 1, is a proteolytic enzyme capable of digesting collagen. Preparations containing clostridiopeptidase A are used topically for the debridement of dermal ulcers, burns and other necrotic lesions to facilitate the formation of granulation tissue and subsequent epithelization. We observed 4 patients with a periulcerative eczema after repeated applications of Noruxol ointment (Smith & Nephew Ltd, L Hull, UK). Patch testing with Noruxol ointment as is and its excipients (soft paraffin and white petrolatum), as well as scaled dilutions of the main ingredient of this topical preparation, clostridiopeptidase A (Firma, Florence, Italy), showed doubtful reactions to Noruxol ointment in 3 patients and a positive reactions only in 1 patient. All patients showed positive reactions to clostridiopeptidase A 1% in pet. This study shows the sensitizing capacity of clostridiopeptidase A that should be tested in all patients with suspect sensitization to Noruxol ointment.
authors.affiliation: Unit of Dermatology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, Policlinico, Piazza Giulio Cesare, 11, I-70124 Bari, Italy. c.foti@dermatologia.uniba.it
authors.forename: Caterina
authors.initials: C
authors.lastname: Foti
authors.forename: Anna
authors.initials: A
authors.lastname: Conserva
authors.forename: Claudia
authors.initials: C
authors.lastname: Casulli
authors.forename: Valentina
authors.initials: V
authors.lastname: Scrimieri
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Pepe
authors.forename: Domenico
authors.initials: D
authors.lastname: Quaranta
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000188:drug therapy; D003646:Debridement / Q000379:methods; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology*; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D003012:Microbial Collagenase / Q000009:adverse effects*; D009824:Ointments / Q000009:adverse effects; D010328:Patch Tests; D012883:Skin Ulcer / Q000188:drug therapy
chemical_list: D003879:Dermatologic Agents; D009824:Ointments; D003012:Microbial Collagenase