title: Allergic contact dermatitis caused by cocamide diethanolamine.
abstract: BACKGROUND
  Cocamide DEA (CAS no. 68603-42-9) is a non-ionic surfactant frequently used in industrial, household and cosmetic products for its foam-producing and stabilizing properties. Contact allergy has been reported quite rarely in the past, but recently several cases were published, raising the question of an increase in the frequency of allergic dermatitis caused by this substance.
  
  
  OBJECTIVE
  To describe cocamide DEA-allergic patients and their characteristics observed in our department.
  
  
  METHODS
  Medical charts of patients, investigated between 1990 and December 2015, were retrospectively reviewed for cocamide DEA-allergy. Demographic characteristics and patch test results were analyzed.
  
  
  RESULTS
  Out of 1767 patients tested, 18 (1%) presented with an allergic reaction to cocamide DEA, all of them at least with hand dermatitis. Twelve patients had (past) occupational exposure to cocamide DEA. Out of the 18 patients, 15 showed (most often) multiple positive reactions and 7 also suffered from atopic dermatitis.
  
  
  CONCLUSIONS
  Cocamide DEA allergy is relatively rare, despite frequent use, and an increasing trend was not observed. Reactions to cocamidopropyl betaine and cocamide MEA only occurred in some of the subjects tested. Shampoos and liquid hand soaps/cleansers dominated as sources of exposure. All patients presented with an impaired skin barrier due to atopic and/or previous contact dermatitis.
authors.affiliation: Department of Dermatology, University Hospitals KU Leuven, 3000 Leuven, Belgium.
authors.forename: Sarien
authors.initials: S
authors.lastname: Mertens
authors.affiliation: Department of Dermatology, University Hospitals KU Leuven, 3000 Leuven, Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Gilissen
authors.affiliation: Department of Dermatology, University Hospitals KU Leuven, 3000 Leuven, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Goossens
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D003876:Dermatitis, Atopic; D009783:Dermatitis, Occupational / Q000209:etiology*; D004983:Ethanolamines / Q000009:adverse effects*; D005260:Female; D005533:Foot Dermatoses / Q000209:etiology; D006229:Hand Dermatoses / Q000209:etiology*; D006801:Humans; D008297:Male; D010328:Patch Tests; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000485:Allergens; D004983:Ethanolamines; C038019:coconut diethanolamide
keywords: CAS no. 68603-42-9; allergic contact dermatitis; atopy; cleansing; cocamide DEA; cocamide MEA; cocamidopropyl betaine; cosmetics; hand dermatitis; skin barrier; surfactant