COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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breast tumor samples; however, it has been suggested that there may have been contamination of the glassware that the samples were processed in from the detergents used by the technicians37,41 The close proximity of the axilla and the breast has further fueled queries as to the possibility of an association of parabens with breast cancer42 This led the Cosmetic Ingredient Review Board to reevaluate the safety of parabens in 200543 The panel determined that the original conclusion on the safety of parabens in cosmetics withstood, and that parabens were shown to have much less estrogenic activity than the body s naturally-occurring estrogen44 Nevertheless, lack of information on the effects of longterm exposure to low levels of parabens and subsequent accumulation in the body TABLE 18-4 Preservatives That Can Cause Contact Dermatitis Benzoic acid Benzyl alcohol Euxyl K 400 (Methyldibromo glutaronitrile and phenoxyethanol) Formaldehyde Formaldehyde-releasing-preservatives (FRPs): Quaternium 15 Imidazolidinyl urea (Germall) Diazolidinyl urea (Germall II) Bromonitropropane diol (Bronopol) DMDM hydantoin Methylchloroisothiazolinone (MCI) P-tert-Butylphenol formaldehyde resin Parabens Propylene glycol Sodium benzoate Toluenesulphonamide Formaldehyde Resin (tosylamide)
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TABLE 18-5 Other Sensitizers Found in Skin and Hair Care Products 2,6-Ditert-butyl-4-cresol (BHT) 2-tert-Butyl-4-methoxyphenol (BHA) 4-Chloro-3-cresol (PCMC) Benzyl alcohol Benzyl salicylate Cetyl alcohol Chloracetamide Chlorhexidine digluconate Isopropyl myristate Lanolin alcohol Propyl gallate Sorbic acid Sorbitan monooleate (Span 80) Sorbitan sesquioleate Stearyl alcohol tert-Butylhydroquinone Triclosan (Irgasan DP 300) Triethanolamine Benzoyl peroxide Cocamide DEA Cocamidopropyl Betaine Di-alpha-tocopherol acetate (vitamin E) Methyl methacrylate Potassium dichromate
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processing and coloring chemicals Toluene sulfonamide formaldehyde resin in nail polish is such a common cause of contact dermatitis that companies such as Sally Hansen and Revlon have developed formaldehyde- and toluene-free nail polish In fact, in some countries such as Switzerland, formaldehyde resins are banned in nail care products Sunscreen ingredients
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TABLE 18-7 Products in Hair Coloring and Processing that Can Cause Skin Sensitization 2,5 Diaminotoluene sulfate 2-Nitro-P-phenylenediamine 3-Aminophenol 4-Aminophenol Ammonium persulfate Ammonium thioglycolate Glyceryl thioglycolate Hydrogen peroxide Hydroquinone Paraphenylenediamine (PPD) Resorcinol
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TABLE 18-8 Sunscreen Ingredients that Can Cause Sensitization 2-Ethylhexyl-4-dimethylaminobenzoate (Eusolex 6007) (Padimate O) (Octyl Dimethyl paba) 2-Ethylhexyl-4-methoxycinnamate (Parsol MCX) 2-Hydroxy-4-methoxy-4methylbenzophenone (Mexenone) 2-Hydroxy-4-methoxy-benzophenon5-sulfonic acid (Sulisobenzone) 2-Hydroxy-4-methoxybenzophenone (Eusolex 4360) 3-(4-Methylbenzyliden)camphor (Eusolex 6300) 4-Aminobenzoic acid (PABA) 4-tert-Butyl-4 -methoxydibenzoylmethane (Parsol 1789) (Avobenzone) Benzophenone-3 (oxybenzone) Homomenthylsalicylate (Homosalate) Isoamyl-p-methoxycinnamate Octyl salicylate (Octisalate) Phenylbenzimidazol-5-sulfonic acid (Eusolex 232)
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involvement, the use of systemic agents such as prednisone, cyclosporine, or ultraviolet light treatments may be indicated The use of ICD corticosteroids is controversial, but seems to be advantageous if applied early
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1 Rietschel RL Clues to an accurate diagnosis of contact dermatitis Dermatol Ther 2004;7:224 2 Jacob SE, Amado A, Cohen DE Dermatologic surgical implications of allergic contact dermatitis Dermatol Surg 2005;31:1116 3 Fisher s In: Rietschel RL, Fowler JF Jr, eds Contact Dermatitis 5th ed Philadelphia, PA: Lippincott Wiliams & Wilkins; 2001 4 Camarasa JG, Lluch M, Serra-Baldrich E, et al Allergic contact dermatitis from 3(aminomethyl)-pyridyl salicylate Contact Dermatitis 1989;20:347 5 de Groot AC, Frosch PJ Adverse reactions to fragrances A clinical review Contact Dermatitis 1997;36:57 6 de Groot A Allergic contact dermatitis In: Marks R, ed Eczema London, UK: Martin Dunitz; 1992:104-125 7 Mekos Laboratories Web site http:// wwwmekosdk/pageasp sideid 2& zcs 27 Accessed November 8, 2005 8 Fischer TI, Maibach HI The thin layer rapid use epicutaneous test (TRUE-test), a new patch test method with high accuracy Br J Dermatol 1985;112:63 9 Uter W, Geier J, Becker D, et al The MOAHLFA index of irritant sodium lauryl sulfate reactions: first results of a multicentre study on routine sodium lauryl sulfate patch testing Contact Dermatitis 2004;51:259 10 Chatard H Case of sensitization to perfumes with cutaneous and general reactions Bull Soc Fr Dermatol Syphiligr 1957;64:323 11 Scheinman PL Allergic contact dermatitis to fragrance: a review Am J Contact Dermat 1996;7:65 12 Johansen JD Fragrance contact allergy: a clinical review Am J Clin Dermatol 2003; 4:789 13 International Fragrance Association (IFRA) Web site http://wwwifraorgorg Accessed January 1, 2007 14 Larsen WG Perfume dermatitis A study of 20 patients Arch Dermatol 1977;113: 623 15 Militello G, James W Lyral: a fragrance allergen Dermatitis 2005;16:41 16 Hjorth N Eczematous allergy to balsams, allied perfumes and flavouring agents, with special reference to balsam of Peru Acta Derm Venereol Suppl (Stockh) 1961;41:1 17 Srivastava D, Chang YT, Kumar S, et al Identification of the constituents of balsam of Peru in tomatoes Poster presentations Dermatitis 2005;16:101 18 Food and Drug Administration Department of Health and Human Services Code of Federal Regulations Food and Drugs http://wwwaccessdatafdagov/ scripts/cdrh/cfdocs/cfcfr/CFRSearchcfm CFRPart 700 &showFR 1 Accessed January 2, 2007 19 Scheinman PL The foul side of fragrance-free products: what every clin-
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have also been reported to cause skin allergy In order to elucidate the cause of contact dermatitis in most patients, a thorough history is crucial Having the patients bring in the offending skin care products, when known, is also necessary