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Contact allergy to imidazole antimycotics
1Department of Dermatology, University of Heidelberg, FRG.
Contact Dermatitis
|February 1, 1988
Summary
Contact allergy to imidazole antimycotics is a concern, with miconazole and clotrimazole being common culprits. Patch testing with 1% active ingredient in ethanol is recommended, and bifonazole may be a safe alternative.
Area of Science:
- Dermatology
- Allergology
- Mycology
Background:
- Imidazole antimycotics are widely used for fungal infections.
- Contact allergy to these agents can occur.
- Identifying causative agents and safe alternatives is clinically important.
Purpose of the Study:
- To report cases of contact allergy to imidazole antimycotics.
- To evaluate patch testing concentrations and vehicles.
- To assess cross-reactivity between imidazole antimycotics.
Main Methods:
- Retrospective analysis of 9 patients with contact allergy.
- Patch testing with various imidazole antimycotics at different concentrations and vehicles (petrolatum, ethyl methyl ketone, ethanol).
- Evaluation of cross-reactivity using bifonazole.
Main Results:
- Miconazole and clotrimazole were the most frequent causes of contact allergy.
- 1% concentration in ethanol was the most effective vehicle for patch testing.
- No cross-reactivity was observed between bifonazole and miconazole or clotrimazole.
Conclusions:
- Contact allergy to imidazole antimycotics, particularly miconazole and clotrimazole, was observed in 9 patients.
- Routine patch testing with 1% imidazole antimycotics in ethanol is recommended.
- Bifonazole appears to be a safe therapeutic alternative for patients allergic to miconazole or clotrimazole due to lack of cross-reactivity.