title: The hazards of moist toilet paper: allergy to the preservative methylchloroisothiazolinone/methylisothiazolinone.
abstract: BACKGROUND
  Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), a common preservative in some brands of moist toilet paper (baby wipes and moist towelettes), has been reported to be a cause of allergic contact dermatitis. However, few cases have been reported in the United States.
  
  
  METHODS
  We report the cases of 4 adult patients with severe perianal and perineal allergic contact dermatitis seen at our institution during a 6-month period. With patch testing, we identified allergy to MCI/MI, and we determined that all 4 patients were using moist toilet paper. The dermatitis resolved after use of the moist toilet paper was discontinued.
  
  
  CONCLUSIONS
  This study highlights that the MCI/MI in moist toilet paper can be a cause of perianal and perineal allergic contact dermatitis.
authors.affiliation: Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Gardner
authors.forename: Mark D P
authors.initials: MD
authors.lastname: Davis
authors.forename: Donna M
authors.initials: DM
authors.lastname: Richardson
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000209:etiology; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010209:Paper; D010502:Perineum / Q000473:pathology; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects*; D013844:Thiazoles / Q000009:adverse effects*
chemical_list: D011310:Preservatives, Pharmaceutical; D013844:Thiazoles; C011506:2-methyl-4-isothiazolin-3-one; C011421:5-chloro-2-methyl-4-isothiazolin-3-one