Methylisothiazolinone allergic contact dermatitis: assessment of relapses in 139 patients after avoidance advice

Background

Methylisothiazolinone (MI) is a preservative responsible for an epidemic of allergic contact dermatitis (ACD). Few studies have been published on the prognosis of patients with MI‐induced ACD.

Objectives

To evaluate relapses of MI‐induced ACD and difficulties in avoiding MI in patients who had received avoidance advice.

Methods

Retrospective study of patients with ACD to MI diagnosed in two specialized dermato‐allergology units between 2010 and 2015. Median follow‐up was 3 years.

Results

Relapses were observed in 64% of 139 included patients and were severe in 18%. "Rinse‐off" cosmetics were responsible for the largest proportion of relapses (27%). Median time to relapse was 5 months. Sixty nine per cent of relapses were on the hands and 29% on the face. Risk factors for relapsing were hand eczema and personal history of atopy. The main difficulties encountered in the avoidance strategy were hidden sources of MI, the lack of labelling on industrial products, the complexity of cosmetic labelling, and remembering the name of the allergen.

Conclusion

MI‐induced ACD has a poor prognosis. Its high rate of relapse is mainly due to the difficulties of avoidance. Management needs to be improved. Specialized follow‐up in the year following diagnosis is essential to educate patients.

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