Contact dermatitis presenting as non-healing wound: case report

Area of Science:

• Dermatology
• Wound Care
• Allergology

Background:

• Topical antiseptics are frequently used for minor wounds and skin infections, often self-prescribed by patients.
• A 73-year-old man presented with a four-week history of a non-healing forearm wound, initially from an insect bite.
• The wound exhibited signs of inflammation and crusting, with a history of self-treatment using a yellow solution.

Purpose of the Study:

• To report a case of allergic contact dermatitis caused by acriflavine, a common topical antiseptic.
• To emphasize the importance of considering contact allergy in non-healing wounds unresponsive to standard treatments.
• To highlight the role of patient education in preventing future contact allergies.

Main Methods:

• Clinical examination of the non-healing wound.
• Patient history including self-treatment with a topical antiseptic.
• Diagnosis confirmed by a positive skin patch test to acriflavine.
• Treatment involved cessation of topical acriflavine and application of saline dressings.

Main Results:

• The patient was diagnosed with allergic contact dermatitis secondary to topical acriflavine.
• Discontinuation of acriflavine and use of saline dressings led to the resolution of the ulcer.
• Skin patch testing confirmed a 2+ positive reaction to acriflavine.

Conclusions:

• Contact allergy to topical antiseptics like acriflavine should be considered in the differential diagnosis of recalcitrant wounds.
• Primary care physicians must be aware of this potential adverse reaction.
• Patient education regarding the safe use of over-the-counter topical agents is crucial for preventing such complications.