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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Case Report

Six Children With Allergic Contact Dermatitis to Methylisothiazolinone in Wet Wipes (Baby Wipes)

Mary Wu Chang and Radhika Nakrani
Pediatrics February 2014, 133 (2) e434-e438; DOI: https://doi.org/10.1542/peds.2013-1453
Mary Wu Chang
aDepartments of Dermatology and Pediatrics, and
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Radhika Nakrani
bMedical Student, University of Connecticut School of Medicine, Farmington, Connecticut
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Abstract

Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a combination preservative used in personal care and household products and is a common cause of allergic contact dermatitis (ACD). Recently, MI alone, without MCI, has been increasingly used in consumer products in attempts to minimize allergic reactions. Wet wipes are extensively tested and traditionally believed to be innocuous. MI in wet wipes (“baby wipes”) has not been previously reported to cause ACD in children in the United States. Only 1 previous report of ACD in a child in Belgium has been recently reported. We report 6 children with chronic, perianal/buttock, and facial eczematous dermatitis, refractory to multiple topical and oral antibiotics and corticosteroids. All tested positive to MCI/MI on patch testing. None wore diapers. All patients had been using wet wipes containing MI (without MCI) to affected areas. Discontinuation of wipes resulted in rapid and complete resolution. This is the first report of pediatric ACD to MI in wet wipes in the United States, and the largest series to date. ACD to MI in wet wipes is frequently misdiagnosed as eczema, impetigo, or psoriasis. Wet wipes are increasingly marketed in personal care products for all ages, and MI exposure and sensitization will likely increase. Dermatitis of the perianal, buttock, facial, and hand areas with a history of wet wipe use should raise suspicion of ACD to MI and prompt appropriate patch testing. Rapid resolution occurs after the allergen exposure is eliminated. All isothiozolinones should be avoided in personal care and household products for these patients.

  • contact dermatitis
  • diaper dermatitis
  • methylisothiazolinone
  • wipes
  • patch testing
  • eczema
  • perioral dermatitis
  • Abbreviations:
    ACD —
    allergic contact dermatitis
    MCI —
    methylchloroisothiazolinone
    MI —
    methylisothiazolinone
    T.R.U.E. Test —
    Thin-layer Rapid Use Epicutaneous Patch Test
    • Accepted August 1, 2013.
    • Copyright © 2014 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 133, Issue 2
    1 Feb 2014
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    Six Children With Allergic Contact Dermatitis to Methylisothiazolinone in Wet Wipes (Baby Wipes)
    Mary Wu Chang, Radhika Nakrani
    Pediatrics Feb 2014, 133 (2) e434-e438; DOI: 10.1542/peds.2013-1453

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    Six Children With Allergic Contact Dermatitis to Methylisothiazolinone in Wet Wipes (Baby Wipes)
    Mary Wu Chang, Radhika Nakrani
    Pediatrics Feb 2014, 133 (2) e434-e438; DOI: 10.1542/peds.2013-1453
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    • Allergy/Immunology
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