Reactions 1704, p238 - 2 Jun 2018 Systemic allergic dermatitis secodary to sodium metabisulphite excipient: case report A 58-year-old man developed recurrent systemic allergic dermatitis caused by mesalazine [Salofalk; Pentasa] containing sodium metabisulphite excipient [dosage not stated]. The man, who had ulcerative colitis, started receiving treatment with oral mesalazine. Rectal mesalazine [Salofalk] enema was added to the therapy. Two days later pruritic erythematous lesions located bilaterally on the inguinal area appeared. The treatment was then switched to rectal mesalazine [Pentasa] enema. However, the lesions recurred. The examination revealed confluent maculopapular lesions with ill-defined borders, with some lesions resembling erythema multiforme, localised in the inguinal area and on the upper thighs. After contact dermatitis was suspected, patch testing with mesalazine [Salofalk], mesalazine [Pentasa] and relevant excipients was performed. On day seven, the patch testing revealed positive results for mesalazine [Salofalk; Pentasa] and sodium metabisulphite. He was diagnosed with systemic allergic dermatitis/ allergic contact dermatitis due to sodium metabisulphite. The man received treatment with oral steroids and the lesions disappeared. The treatment with mesalazine [Pentasa] enema was discontinued. He had experienced a similar episode previously for a period of two days after drinking wine. He was advised to avoid sulphites in diet. Follow-up six months after revealed no cutaneous lesions. Author comment: "In this patient, positive patch test reactions to sodium metabisulfite and the enemas containing this antioxidant, the occurrence of a bilateral inguinal eczematous rash following the use of enemas, clearing on withdrawal, good tolerance to oral mesalazine and the absence of other possible culprits supports the diagnosis of systemic allergic dermatitis caused by sodium metabisulfite present in the enemas." Borges AS, et al. Systemic allergic dermatitis caused by sodium metabisulfite in rectal enemas. Contact Dermatitis 78: 429-430, No. 6, Jun 2018. Available from: URL: http://doi.org/10.1111/cod.12971 - Portugal 803323463 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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