Allergic contact dermatitis to 2-bromo-2-nitropropane-1,3-diol in a hydrophilic ointment

Seven patients are described who developed acute allergic contact dermatitis after using Eucerin cream on previously dermatitic skin for periods of time varying from 5 weeks to 2 years. Eucerin was preserved with 2-bromo-2-nitropropane-1,3-diol (BNPD) in 1978 to assist in controlling a problem with Pseudomonas aeruginosa contamination. All of our patients were BNPD and Eucerin patch test-positive. None of them was allergic to formaldehyde or to any other preservative known to be a formaldehyde donor. This was in contrast to other BNPD and other formaldehyde-releaser--sensitive patients we saw in 1979-1980, who often had positive patch test reactions throughout this group of preservatives. BNPD is difficult to patch test with because it is often an irritant, even in low concentrations. We discuss some patch test "lessons" which our experiences with these patients accentuated for us.