title: Occupational allergic contact dermatitis caused by coconut fatty acids diethanolamide.
abstract: BACKGROUND
  Coconut fatty acids diethanolamide [cocamide diethanolamine (cocamide DEA)] is a surface-active derivative of coconut oil that is used in industrial, household and cosmetic products. Cocamide DEA contact allergy has been reported relatively seldom.
  
  
  OBJECTIVE
  To describe cocamide DEA-positive patients in an occupational dermatology clinic.
  
  
  METHODS
  We retrieved allergic reactions to cocamide DEA from test files, and studied the occupation, exposure, concomitant allergic reactions and diagnoses of the positive patients.
  
  
  RESULTS
  Of the 2572 patients tested, 25 (1%) had an allergic reaction to cocamide DEA. Nineteen patients were occupational cases, and 11 worked in the metal industry. Hand cleansers constituted the main source of sensitization (n = 17). Other sources included two dishwashing liquids, one barrier cream, and one metalworking fluid. Three patients reacted to monoethanolamine and 2 to diethanolamine. Diethanolamine is an impurity of cocamide DEA, and can be found in cocamide DEA-containing products and in commercial patch test substances, which may explain some concomitant reactions.
  
  
  CONCLUSIONS
  Cocamide DEA allergy is relatively common in patients with occupational hand dermatitis, and mainly derives from hand cleansers. However, exposure to detergents, metalworking fluids and barrier creams must also be taken into account. Concomitant reactions to ethanolamines are possible.
authors.affiliation: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health (FIOH), Helsinki, FI-00250, Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Aalto-Korte
authors.forename: Maria
authors.initials: M
authors.lastname: Pesonen
authors.forename: Outi
authors.initials: O
authors.lastname: Kuuliala
authors.forename: Katri
authors.initials: K
authors.lastname: Suuronen
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects; D003059:Cocos; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology*; D003902:Detergents / Q000009:adverse effects*; D004983:Ethanolamines / Q000009:adverse effects*; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000175:diagnosis; D006235:Hand Disinfection; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D010938:Plant Oils / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000485:Allergens; D003902:Detergents; D004983:Ethanolamines; D010938:Plant Oils; C038019:coconut diethanolamide
keywords: barrier cream; diethanolamine; dishwashing liquid; hand cleanser; metal industry; metalworking fluid; monoethanolamine