title: Swimming pool contact dermatitis caused by 1-bromo-3-chloro-5,5-dimethyl hydantoin.
abstract: BACKGROUND
  Bromo-3-chloro-5,5-dimethylhydantoin (BCDMH) is a chemical used as a disinfectant for recreational water. BCDMH was described as being responsible for an epidemic of irritant contact dermatitis in the UK (1983), and its sensitizing capacity was also discussed.
  
  
  OBJECTIVE
  The aim of this study was to assess whether BCDMH used to disinfect swimming pools and spas can cause allergic contact dermatitis among its users.
  
  
  METHODS
  Ten patients suffering from dermatitis associated with using swimming pools disinfected with BCDMH and 40 controls were studied. Several dilutions of BCDMH, 10% to 1 ppm, were patch tested.
  
  
  RESULTS
  All 10 patients studied showed a positive patch test reaction to BCDMH 1% in petrolatum. At least one case showed occupational relevance, with a positive reaction even at 1 ppm.
  
  
  CONCLUSIONS
  On the basis of the clinical findings, the positive patch test reactions to BCDMH, and the negative patch test reactions in controls, the suggested diagnosis was allergic contact dermatitis caused by BCDMH used as a disinfectant in the swimming pool water. Contact allergy should be taken into consideration when patients suffer from swimming pool-associated itchy dermatitis.
authors.affiliation: Department of Allergy, Dermatology and Pharmacy, Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Spain.
authors.forename: Gaspar
authors.initials: G
authors.lastname: Dalmau
authors.forename: Maria Estela
authors.initials: ME
authors.lastname: Martínez-Escala
authors.forename: Vanessa
authors.initials: V
authors.lastname: Gázquez
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Pujol-Montcusí
authors.forename: Laura
authors.initials: L
authors.lastname: Canadell
authors.forename: Mercé
authors.initials: M
authors.lastname: Espona Quer
authors.forename: Ramón M
authors.initials: RM
authors.lastname: Pujol
authors.forename: Joan
authors.initials: J
authors.lastname: Vilaplana
authors.forename: Pere
authors.initials: P
authors.lastname: Gaig
authors.forename: Ana
authors.initials: A
authors.lastname: Giménez-Arnau
mesh_terms: D000328:Adult; D000368:Aged; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D004202:Disinfectants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006827:Hydantoins / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D013551:Swimming Pools
chemical_list: D004202:Disinfectants; D006827:Hydantoins; C039283:di-halo