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Related Experiment Videos

Co-existing sensitivity to metronidazole and isothiazolinone.

R Wolf1, E Orion, H Matz

  • 1The Dermatology Unit, Kaplan Medical Center, Rechovot, Israel. wolf_r@netvision.il

Clinical and Experimental Dermatology
|September 3, 2003
PubMed
Summary

A woman experienced allergic contact dermatitis to metronidazole gel, likely due to cross-reactivity with methylchloroisothiazolinone and methylisothiazolinone. This suggests metronidazole allergy may be more common than previously thought.

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Area of Science:

  • Dermatology
  • Allergology
  • Toxicology

Background:

  • Topical metronidazole is frequently prescribed for various skin conditions.
  • Allergic contact dermatitis (ACD) is a common adverse reaction to topical medications.
  • Isothiazolinones (e.g., methylchloroisothiazolinone/methylisothiazolinone) are prevalent preservatives and frequent causes of ACD.

Observation:

  • A 68-year-old female patient presented with ACD to topical metronidazole gel.
  • Patch testing confirmed allergy to the metronidazole gel and the active ingredient, metronidazole.
  • The patient also had a known allergy to methylchloroisothiazolinone/methylisothiazolinone (MC/MI).

Findings:

  • The patient exhibited a rapid reaction to metronidazole gel (1-day incubation), suggesting pre-existing sensitization.

Related Experiment Videos

  • Structural similarities between metronidazole and isothiazolinones support a plausible cross-reaction.
  • Positive patch tests confirmed allergies to both metronidazole and MC/MI.

    • Implications:

    • This case highlights a potential cross-reactivity between metronidazole and isothiazolinones.
    • It suggests that metronidazole allergy might be underdiagnosed and potentially more prevalent than current literature indicates.
    • Clinicians should consider isothiazolinone cross-reactivity in patients with suspected metronidazole allergy.