Generalized exfoliative dermatitis from ethylenediamine

Area of Science:

• Pharmacology
• Dermatology
• Allergy and Immunology

Background:

• A patient with a known allergy to Mycolog, a topical antibiotic cream containing nystatin, neomycin sulfate, gramicidin, and triamcinolone acetonide, was administered aminophylline.
• The patient had a history of allergic reaction to the topical preparation.

Observation:

• Following administration of aminophylline, the patient developed a generalized exfoliative dermatitis.
• The observed skin reaction was severe and widespread.

Findings:

• The severe dermatological reaction was attributed to ethylenediamine hydrochloride.
• Ethylenediamine hydrochloride was identified as a common component in both the topical cream (Mycolog) and the systemic medication (aminophylline).

Implications:

• This case underscores the potential for systemic medications to trigger allergic reactions in patients with prior sensitivities to related topical agents.
• Clinicians must be aware of cross-reactivity risks, particularly with ingredients like ethylenediamine hydrochloride, when prescribing systemic drugs to patients with known topical allergies.