R. Corso, I. White, J. McFadden
Feb 1, 2021
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Quality indicators
Journal
Contact Dermatitis
Abstract
A 32-year-old nonatopic male scientist presented with a 6-month history of patchy eczema, which initially affected the periorbital area, eyebrows, and cheeks before spreading to the neck, followed by lip swelling and cracking. He had worked for a pharmaceutical company for over 10 years, creating novel pharmaceutical compounds. He routinely used a fume cupboard and wore gloves, laboratory coat, and googles while working. He reported settling of the eczema when on holidays, with quick recurrence on return to work. Since changing to an office-based role he experienced near-complete resolution of symptoms. Patch tests were performed to an extended European baseline series, labeled fragrance series, face series, and additional rubber chemical accelerators, and to all suspected causative drug compounds provided by the pharmaceutical company (employer), including nalmefene hydrochloride (CAS no. 58895-64-0) 0.1% aq. Finn Chambers (Bio-Diagnostics, Upton-Upon-Severn, United Kingdom) were used and allergens from Chemotechnique (Vellinge, Sweden). Readings were performed on day (D)3 and D5, conforming to European Society of Contact Dermatitis guidelines. On D3 there was a positive (++) reaction to nalmefene hydrochloride. This was repeated, and at the second reading the only positive reactions were to both test sites for nalmefene hydrochloride 0.1% aq. Responses to appropriate escalating concentrations of other employer-provided suspected agents were negative. Subsequently 20 controls were patch tested to the nalmefene hydrochloride at 0.1% aq., all of which were negative.