| Table 3-5 Contact Allergens |
| Formaldehyde-Releasing Preservatives |
| | Quaternium-15 | | Most common cosmetic preservative to cause ACD; personal care products |
| | 2-Bromo-2-nitropropane-1,3-diol (Bronopol) | | Formaldehyde-releasing preservative in personal care products and variety of industrial applications |
| | Diazolidinyl urea (Germall II) | | Formaldehyde-releasing preservative; personal care products (especially bubble baths, baby wipes and household detergents) |
| | Imidazolidinyl urea (Germall 115) | | Formaldehyde-releasing antimicrobial preservative used in cosmetics |
| | DMDM hydantoin | | Formaldehyde-releasing antimicrobial preservative used in cosmetics like shampoo, hair conditioners and skin care products |
| Rubber accelerators |
| | Thiuram | | Rubber in shoes, rubber gloves, elastic, fungicides, paints, barrier contraceptives
{Thiuram cross reacts w/ disulfiram} |
| | Mercaptobenzothiazole (MBT) | | Most common cause of allergic shoe dermatitis |
| | | Rubber products, tires, antifreeze, anticorrosive agents, cutting oils, electrical cords, fungicides, rubber shoes (sneakers, tennis shoes, etc.) |
| | Carba mix | | Leather shoes, tires, fungicides, cosmetic applicators, gloves, adhesives, elastic, barrier contraceptives; may cross react with thiuram derivatives
{Repeated washing of elastic (ie. undergarments) with hypochlorite (bleach) causes elastic to become more allergenic (due to ↑ availability of carbamates), which may result in ‘elastic dermatitis’ or ‘bleached rubber syndrome’ (but patch test negative for rubber accelerators)} |
| | Mercapto mix | | Tires, elastic, rubber gloves, electrical cords, rubber soles of shoes, etc. |
| | Black rubber mix | | Heavy-use rubber products such as tires, hoses, cables and belts |
| | Mixed dialkyl thioureas | | Neoprene rubber (wetsuit), goggles, elastic, paint remover, shoe insoles |
| Textiles |
| | Disperse blue 106 | | Clothing dye (bed linens, blue dye, clothing, tights, garment lining) |
| | Ethylene urea melamine
formaldehyde mix | | Permanent press clothing (wrinkle-resistant)
{Textile dermatitis typically occurs where clothing fits tightly (posterior neck, upper back, lateral thorax, axillae, waistband, flexor surfaces); ± purpuric contact dermatitis} |
| Adhesives |
| | Epoxy resin (bisphenol A) | | Glues, plastics, electrical insulation, paint and primer |
| | Colophony (rosin, abietic acid) | | Paper, cosmetics, paint, adhesives, waxes, chewing gum, used in baseball/ ballet/musical instruments to ↑ friction |
| | Cyanoacrylate (methyl or ethyl) | | Fast-acting adhesive (Super or Krazy Glue), liquid bandages, Dermabond |
| | Ethyl acrylate | | Artificial nail (adhesive) |
| | Methacrylate (methyl or ethyl) | | Adhesive, artificial nails, dental fillings/sealants, hearing aids, hard contact lenses, glue (bone cement) for artificial joints, acrylic denture material
{May diffuse through intact surgical glove and cause paresthesias (i.e. most commonly seen in either dentist or orthopedic surgeon)} |
| | p-tert-butylphenol formaldehyde resin | | Leather/rubber adhesive |
| Sunscreen components |
| | Benzophenone-3 | | Sunscreens, rubber products, cosmetics |
| | PABA (Padimate O) | | Sunscreen (UVB)
{PABA ± cross react w/ sulfonamides, azo dyes, benzocaine, PPD} |
| | Oxybenzone | | Sunscreen (UVA)
{Oxybenzone: most common sunscreen agent to cause photoallergic contact dermatitis} |
| Corticosteroids |
| | Tixocortol-21-pivalate | | Group A (hydrocortisone acetate, prednisone, methylprednisolone) |
| | Budesonide | | Group B (triamcinolone acetonide, desonide, fluocinolone acetonide, fluocinonide, halcinonide)
{Budesonide also marker for some Gr. D steroids} |
| | Hydrocortisone-17-butyrate | | Group D (hydrocortisone-17-valerate/butyrate, clobetasone-17-butyrate clobetasol proprionate, betamethasone valerate/diproprionate) |
| Hair preparations |
| | Paraphenylenediamine (PPD) | | Permanent hair dye, ‘black henna’ (not natural henna from plant), photographic developer, printing inks, black rubber, temporary tattoos |
| | | ACD typically on eyelids/ear helices/hairline or hands
{May cross react with: PABA, sulfonamides (including thiazide and furosemide), para-aminosalicylic acid, benzocaine and procaine (ester anesthetics), azo dyes (temporary/semi-permanent hair dye, pen ink, coloring agent)} |
| | Monothioglycolate | | Permanent wave preparations; typically in glycerol monothioglycolate |
| | Ammonium persulfate | | Hair bleach, bleaching agent in flour |
| Others |
| | Bacitracin | | Topical antibiotic ointment, otic and ophthalmic preparations |
| | Balsam of Peru | | Naturally occurring fragrance material, found in topical medications |
| | Benzalkonium chloride | | Skin disinfectant (ophthalmic solutions), cosmetics |
| | Benzocaine, tetracaine | | Local anesthetic (ester)
{May cross-react with PABA, PPD, and sulfonamides} |
| | Cobalt | | Added to other metals to ↑ hardness; found in jewelry, buttons, cosmetics, hair dye, joint replacements, ceramics, enamel, cement, paint, and pottery |
| | Cocamidopropyl betaine | | Hair and bath products like shampoo (surfactant) |
| | Ethylenediamine | | Medical creams, antifreeze, paint
{Cross-reacts with hydroxyzine and aminophylline} |
| | Euxyl K400 | | Cosmetic and household products (preservative) |
| | Fragrance mix | | Several components (cinnamic aldehyde), detects 70% fragrance allergies |
| | Formaldehyde | | Textile resins (wrinkle-free clothing), cosmetics, tissue fixative, embalming solution, paints, disinfectants, and medications |
| | Gold | | Jewelry, dentistry, electronics, treatment of certain diseases (RA, SLE, etc.) |
| | Glutaraldehyde | | Cold sterilization (medical/dental equipment), disinfectant, tan shoe leather |
| | Lanolin (wool alcohol) | | Cosmetics and some topical creams |
| | Methylchloroisothiazolinone
(Kathon CG) | | Preservative in cosmetics and shampoos (antibacterial properties) |
| | Neomycin sulfate | | Antibiotic ointment, hemorrhoidal cream, otic and ophthalmic preparations |
| | | Co-sensitivity often between neomycin and bacitracin |
| | Nickel sulfate | | Costume jewelry, buckles, and snaps; dimethylglyoxime test detects nickel (positive if turns pink); ± co-sensitivity seen with nickel and cobalt |
| | Paraben mix | | Cosmetics, topical medications, food, textiles, antiperspirants |
| | Potassium dichromate | | Cement, leather (footwear), plaster, wood finishes, green felt of card tables |
| | Propylene glycol | | Cosmetics, topical medications (vehicle), antifreeze |
| | Thimerosal | | Preservative in contact lens solution, vaccines, otic/ophthalmic solution, antiseptic
{↑ photosensitivity with piroxicam if patient with positive reaction to thimerosal} |
| | Tocopherol acetate | | Vitamin E |
| | Toluene sulfonamide
{Also known as tosylamide sulfonamide formaldehyde resin} | | Nail polish (typically appears as eyelid dermatitis or periungual dermatitis) |
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