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Dermatitis. 2012 Jul-Aug;23(4):162-6. doi: 10.1097/DER.0b013e318260d78d.

Sensitization prevalence for benzalkonium chloride and benzethonium chloride.

Author information

1
Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH, USA.

Abstract

BACKGROUND:

Benzalkonium chloride (BAK) and benzethonium chloride (BEC) are well-characterized skin irritants and rare sensitizers, but optimal testing for allergic contact dermatitis (ACD) is not established.

OBJECTIVE:

Sensitization prevalence was sought, and several patch testing concentrations and vehicles were compared.

METHODS:

One hundred forty-two patients tested to the standard screening series for evaluation of dermatitis consented to additional tests including BAK 0.15% aqueous (aq), BAK 0.15% petrolatum (pet), BEC 0.15% aq, and BEC 0.5% aq. Follow-up to assess clinical relevancy included early and late patch test reads, 1-month clinical follow-up, and long-term phone calls. Patients were categorized as definite, possible, or unlikely to have ACD to BAK and/or BEC.

RESULTS:

Atopy was not associated with patch test reactions (P = 0.154). Seventy-five percent (6/8) of the patients with possible ACD to BAK had coreactions with BEC. Testing to both BAK 0.15% pet and 0.15% aq would have identified 91% of those with possible ACD to BAK, twice as many than if only BAK 0.1% aq from the standard series was used.

CONCLUSION:

Sensitization to BAK and BEC, although rare, does occur. Weak and morphologically irritant reactions at day 7 reading can be relevant. We recommend testing to BAK 0.15% aq and 0.15% pet to increase sensitivity and having patients undergo long-term follow-up.

PMID:
22828255
DOI:
10.1097/DER.0b013e318260d78d
[Indexed for MEDLINE]

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