Allergic contact dermatitis from retinoic acid

Allergic contact dermatitis from vitamins: A systematic review

Background and Aims

Vitamins are bioactive compounds naturally found in many different types of food and required by the human body for many biological functions and enzymatic activities. Due to their antioxidant properties, certain vitamin derivatives have been synthesized for inclusion in many cosmetics, thus leading to an increasing incidence of allergic contact dermatitis (ACD) cases. Therefore, the present review may be helpful to provide an insight into the sensitizing role of at least certain vitamins and may also offer possible patch test alternatives for definitive diagnosis.

Methods

This study was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Literature search regarding ACD cases to vitamins was performed using the Medline, PubMed, Scopus, EMBASE, and Google Scholar databases from January 1940 up to June 2021.

Results

A total of 4494 articles matched the keywords used for the researched. Records removed before screening included 15 duplicate articles and 3429 not eligible articles (e.g., not written in English, studies on animals, not relevant to the topic). A total of 1050 articles underwent the screening phase and 258 were therefore excluded as they were not primary studies. Subsequentially, 792 articles were considered eligible for the review and 688 of them were finally excluded as they did not report the outcome of interest. Therefore, 104 articles were definitely included in the present review.

Conclusion

ACD to vitamins is still probably an underestimated issue in cosmetology, as many vitamins are considered "natural" and therefore "safe" ingredients. On the contrary, according to current literature, almost all vitamins contained in topical products are able to induce allergic reactions, with the exception of vitamin B2 and vitamin B9. Patch tests are not standardized, thus leading to difficulties in diagnosis.

Irritant contact dermatitis, multiple pyogenic granulomas and vitiligo following topical application of tretinoin

A 65-year-old women presented with sharply demarcated macules and small nodules on her face and neck for 2.5 years. They first appeared on her left face and gradually spread to her whole face and neck. The lesions were slightly pruritic. Her history was remarkable only for a high dose of topical tretinoin cream 0.025% dosage. On the basis of distribution and history, we made the diagnosis of contact dermatitis for the macules. A biopsy of a red papule from her neck revealed characteristics of pyogenic granuloma. However, white patches appear on his face at the third month follow-up after suspension of the tretinoin cream; Wood's lamp examination was consistent with vitiligo. It is the first report of a dose-response variant of this adverse reaction (Contact dermatitis combined with Pyogenic granulomas).

Contact dermatitis to topical acne drugs: a review of the literature

Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild-moderate acne and is known as well-tolerated thanks to its low systemic toxicity, although associated to skin adverse effects. Acne seems to be associated also to an intrinsic alteration of the epidermal barrier, regarding both the upper and the follicular stratum corneum that promotes the onset of such local side effects. The commonest one is irritant contact dermatitis, an event of frequent observation occurring with erythema, burning, dryness, scaling, and itching, usually characterized by low severity and limited duration. Among topical acne drugs, retinoids are the most irritating ones. Another side effect is allergic contact dermatitis: it is rare and mainly associated to benzoyl peroxide.