B. Dharmagunawardena, R. Charles-Holmes
Apr 1, 1997
Citations
0
Influential Citations
4
Citations
Quality indicators
Journal
Contact Dermatitis
Abstract
Case Report A 46-year-old man presented with a recurrent pruritic rash affecting the groins and scrotum, for which he had applied I% clotrimazole (Canesten) cream for a number of years. Although the eruption initially responded well, it subsequently failed to clear and he developed a more widespread eczematous eruption. Exacerbations occurred within days of application of the cream. There was no history of other topical medicament use. He was initially patch tested to the European standard series, a corticosteroid series and Canesten cream, showing a positive reaction ( + +) to Canesten cream at D2 and D4. The remainder of the tests were negative. The constituents ofCanesten cream (clotrimazole 1%, sorbitan stearate 2%, polysorbate 60 1.5%, cetylpalmitate 3%, cetylstearyl alcohol 10%, octyldodecanol 13.5%, and benzyl alcohol 1%) were obtained through Bayer Pharmaceuticals. The vehicle used by the manufacturer for clotrimazole and benzyl alcohol was 96% ethanol, whilst for the other constituents, it was liquid paraffin. The patient was patch tested to them. There was a positive reaction to octyldodecanol 13.5% in liquid paraffin on D2 ( +) and D4 ( + + ). This was then diluted to I 0%, 5% and 1% (of 13.5% of octyldodecanol) in liquid paraffin and further patch testing carried out at these concentrations. Patch tests were positive to 1 0'% D2 ( +) D4 (++), 5% D2 (+) D4 (++)and 1% D2 (-) D4 (+).