Sorbitan sesquioleate: an emerging contact allergen

Sorbitol-based emulsifiers such as sorbitan sesquioleate (SSO) are commonly used in topical corticosteroids, topical antibiotics, topical antifungals, moisturizing creams and lotions, and topical retinoids. Contact dermatitis from sorbitol derivatives appears to be increasingly prevalent. Patch-testing with SSO can be useful in the work-up of patients with presumptive cosmetic allergic contact dermatitis. Those sensitized to SSO can be counseled to avoid sorbitol-containing products, especially topical corticosteroids. Herein we discuss case reports of SSO allergy and a recent case series of 12 of 112 dermatitis patients (10.7%) patch-tested during a 6-month period who showed contact allergy to SSO. We provide a list of key corticosteroids and products that can contain SSO, sorbitol, or sorbitol derivatives.