Is the irritant benzalkonium chloride a contact allergen? A contribution to the ongoing debate from a clinical perspective

Is the irritant benzalkonium chloride a contact allergen? A contribution to the ongoing debate... Background: Benzalkonium chloride (BAC) is a well‐recognized irritant. However, doubts exist that it is also a contact allergen. Objective: Analysis of clinical patch test data addressing the reaction profile and synchronous reproducibility of BAC 0.1% in petrolatum (pet.) and possible increases in risk of BAC contact allergy in certain (occupationally exposed) subgroups. Patients /Methods: Data of 42 898 patients tested with BAC 0.1% in pet. in 3 different series (topical drugs, ophthalmics, and disinfectants) in the departments of the Information Network of Departments of Dermatology (http://www.ivdk.org) between 1996 and 2006 was analysed. Results: Overall, morphologically ‘positive’ reactions were rare, 0.6–1.5%, with a total of 41 stronger positive reactions. Concordance, assessed in 3322 patients tested in duplicate, was low (kappa coefficient 0.15, 95% CI: 0–0.31). Positive test reactions were observed significantly more often in the disinfectants series compared with the 2 other series, indicating that suspected exposure to disinfectants may be associated with sensitization. However, variation of stronger BAC test positivity across potentially relevant (occupational) groups was non‐significant. Conclusion: This analysis of routine clinical data and a number of previous reports add further, if weak, evidence to the notion that BAC is a contact allergen, albeit a very rare one. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Contact Dermatitis Wiley

Is the irritant benzalkonium chloride a contact allergen? A contribution to the ongoing debate from a clinical perspective

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Publisher
Wiley
Copyright
© 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard
ISSN
0105-1873
eISSN
1600-0536
DOI
10.1111/j.1600-0536.2008.01327.x
pmid
18503686
Publisher site
See Article on Publisher Site

Abstract

Background: Benzalkonium chloride (BAC) is a well‐recognized irritant. However, doubts exist that it is also a contact allergen. Objective: Analysis of clinical patch test data addressing the reaction profile and synchronous reproducibility of BAC 0.1% in petrolatum (pet.) and possible increases in risk of BAC contact allergy in certain (occupationally exposed) subgroups. Patients /Methods: Data of 42 898 patients tested with BAC 0.1% in pet. in 3 different series (topical drugs, ophthalmics, and disinfectants) in the departments of the Information Network of Departments of Dermatology (http://www.ivdk.org) between 1996 and 2006 was analysed. Results: Overall, morphologically ‘positive’ reactions were rare, 0.6–1.5%, with a total of 41 stronger positive reactions. Concordance, assessed in 3322 patients tested in duplicate, was low (kappa coefficient 0.15, 95% CI: 0–0.31). Positive test reactions were observed significantly more often in the disinfectants series compared with the 2 other series, indicating that suspected exposure to disinfectants may be associated with sensitization. However, variation of stronger BAC test positivity across potentially relevant (occupational) groups was non‐significant. Conclusion: This analysis of routine clinical data and a number of previous reports add further, if weak, evidence to the notion that BAC is a contact allergen, albeit a very rare one.

Journal

Contact DermatitisWiley

Published: Jun 1, 2008

References

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