Pustular Allergic Contact Dermatitis caused by colophonium i
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Allergic contact dermatitis (ACD) from epilating products is an emerging problem. The clinical appearance of an ACD can be atypical, maybe pustular looking like acute generalized pustulosis.

A 40-year-old non-atopic woman presented with a recent pruritic pustular eruption 15 hours after wax epilation reported while applying a dispersible paracetamol (DOLIPRANE®) and BIAFINE® cream after the face waxing. There was a history of immediate allergic reaction type urticaria and angioedema to paracetamol administered orally. Dermatological examination revealed erythematous edematous plaques with multiple pustules involving the eyebrow, the peri-orbicular region, and the upper lip associated with marked pruritus.

The skin biopsy showed acanthosis and spongiosis with superficial vesicle containing neutrophils. The underlying dermis contained a perivascular, inflammatory infiltrate. The patient was treated with a short course of topical corticosteroids. A resolution of the eruption was obtained in few days. The patient was patch tested with Standard European baseline series, DOLIPRANE® and BIAFINE® cream applied in Finn Chambers® on Scanpor® tape.

DOLIPRANE® patch test was performed with DOLIPRANE® 30% pet. and 30% aq. The patch tests were applied on the upper back for 2 days. Readings were performed on the day 2 and D3. Patch test results were positive for colophonium (++/+++). Patch tests with DOLIPRANE® and BIAFINE® cream were negative. Oral provocation test with DOLIPRANE® was negative. The wax epilation product used was found to contain colophonium. Pustular allergic contact dermatitis caused by colophonium was diagnosed.

Source: https://onlinelibrary.wiley.com/doi/abs/10.1111/cod.13695?af=R