title: Allergic contact dermatitis to mafenide acetate: a case series and review of the literature.
abstract: Burn patients with extensive involvement of body surface area (BSA >30%) represent a challenge in wound treatment. Multiple topical agents may be used for cleansing, barrier protection, and antimicrobial control leading to complications of contact and/or irritant dermatitis, which may further complicate re-epithelization and eventual wound healing. We present 4 patients who sustained extensive burns during Operation Iraqi Freedom/Operation Enduring Freedom and later developed contact dermatitis to mafenide acetate, a common topical antimicrobial used in burn care treatment, also known as Sulfamylon (alpha-amino-p-toluenesulfonamide monoacetate). All patients who were patch tested to mafenide acetate 7% solution were positive. A rechallenge with mafenide acetate resulted in recrudescence of the eruption in 2 out of the 4 patients. Though cutaneous reactions to mafenide acetate were reported by Yaffe and Dressler in 1969, the most recent case reports are from 1995. This paper presents more recent examples of cutaneous reactions to mafenide acetate, while also reviewing the literature.
authors.affiliation: Columbia College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Elnaz F
authors.initials: EF
authors.lastname: Firoz
authors.forename: Bahar F
authors.initials: BF
authors.lastname: Firoz
authors.forename: James F
authors.initials: JF
authors.lastname: Williams
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Henning
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000009:adverse effects / Q000627:therapeutic use; D001753:Blast Injuries / Q000188:drug therapy; D002056:Burns / Q000188:drug therapy; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007493:Iraq; D008272:Mafenide / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008889:Military Personnel; D014481:United States; D014857:Warfare
chemical_list: D000891:Anti-Infective Agents, Local; D008272:Mafenide