title: Insect repellents and contact urticaria: differential response to DEET and picaridin.
abstract: Topical insect repellent is commonly used throughout the world. Active ingredients typically include N,N-diethyl-meta-toluamide (DEET) or picaridin. Reactions to topical repellents have ranged from contact dermatitis to urticaria. Exposure to DEET can produce contact urticaria; however, it is unknown if patients with a sensitivity to DEET can tolerate picaridin. We report the case of a 22-year-old man who presented for evaluation of contact urticaria that had developed immediately after the application of insect repellent and contact with individuals who had used DEET-containing repellents. No systemic manifestations were noted. Commercially available products containing DEET or picaridin were used for open patch testing. The patient showed immediate urticarial responses to 7% DEET and 7% DEET in ethanol, but patch tests for 5% picaridin and 5% picaridin in ethanol were negative. Based on these results, we conclude that insect repellents containing picaridin may be acceptable alternatives in patients who demonstrate sensitivity to products containing DEET.
authors.affiliation: Largo Medical Center, Nova Southeastern University, FL, USA. brandon.shutty@med.lecom.edu
authors.forename: Brandon
authors.initials: B
authors.lastname: Shutty
authors.forename: David
authors.initials: D
authors.lastname: Swender
authors.forename: Leah
authors.initials: L
authors.lastname: Chernin
authors.forename: Haig
authors.initials: H
authors.lastname: Tcheurekdjian
authors.forename: Robert
authors.initials: R
authors.lastname: Hostoffer
mesh_terms: D000328:Adult; D003671:DEET / Q000009:adverse effects*; D006801:Humans; D007302:Insect Repellents / Q000009:adverse effects*; D008297:Male; D010328:Patch Tests; D010880:Piperidines / Q000009:adverse effects*; D014581:Urticaria / Q000139:chemically induced* / Q000175:diagnosis; D055815:Young Adult
chemical_list: D007302:Insect Repellents; D010880:Piperidines; D003671:DEET; C483506:picaridin