title: Worsening of contact dermatitis by oral hydroxyzine: a case report.
abstract: Hydroxyzine is commonly used to treat pruritic skin lesions. Although rare, hydroxyzine can sometimes be linked to worsening dermatitis in patients who have sensitivities to phenothiazines and/or ethylenediamines. Herein we describe a patient who developed papulovesicular eruptions following the use of topical neomycin. Our patient's contact dermatitis initially improved after the use of oral steroids. However, the patient's skin condition was exacerbated by the continued use of hydroxyzine to treat her pruritus. Patch testing was positive at 48 hours for neomycin sulfate, ethylenediamine dihydrochloride, and p-phenylenediamine. Given the suspected cross-reactivity between hydroxyzine and ethylenediamine, hydroxyzine was discontinued and the patient's cutaneous symptoms improved. In summary, physicians must be aware that oral hydroxyzine can worsen contact dermatitis in ethylenediamine-sensitive patients.
authors.affiliation: Division of Allergy/Immunology, Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Nianda
authors.initials: N
authors.lastname: Reid
authors.forename: Sunit
authors.initials: S
authors.lastname: Jariwala
authors.forename: Golda
authors.initials: G
authors.lastname: Hudes
authors.forename: Jason
authors.initials: J
authors.lastname: Fodeman
authors.forename: Elina
authors.initials: E
authors.lastname: Jerschow
authors.forename: David
authors.initials: D
authors.lastname: Rosenstreich
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000982:Antipruritics / Q000008:administration & dosage / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000188:drug therapy*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005029:Ethylenediamines / Q000009:adverse effects; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage / Q000009:adverse effects*; D009355:Neomycin / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D000982:Antipruritics; D005029:Ethylenediamines; D006919:Hydroxyzine; D009355:Neomycin