Contact dermatitis due to topical treatment with garlic in Hong Kong

Contact dermatitis due to garlic is usually due to handling of garlic for cooking. Among the Chinese, garlic is also used as a form of topical medicament. 8 patients developed contact dermatitis after rubbing the cut end of a fresh garlic bulb onto the skin to treat fungal and other infections at the groin, neck, lower limb, hand or face. The distribution and morphology of the lesions were different from the classical form as described in the literature. Repeated open application tests with fresh garlic were all positive and patch tests with garlic extract were all negative. 5 controls tested by repeated open application with fresh garlic juice were also positive and patch tests in 10 controls with garlic extract were also negative. The results confirmed that the contact dermatitis was due to irritation. The patients were treated successfully with topical fluorinated steroid. For prevention, the practice of direct application of fresh garlic onto the skin for treating infections should be discouraged.