PMC10086826_01
(A-C) Severe allergic contact dermatitis with secondary generalization caused by etofenamate and Symcalmin. (D) Positive patch test on Day 4 to Traumalix DOLO gel 5% (+++) and Bepanthen Sensiderm (++). (E) Positive patch test on Day 4 to etofenamate 2% pet (+++). (F) Positive patch test on Day 4 to Symcalmin, 5% solution of HPPBA in a vehicle of (1:1), butylene glycol and pentylene glycol, tested at the same concentration as in Bepanthen Sensiderm (++)
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The rash had initially appeared on her left forearm and had secondarily spread to the trunk and limbs (Figure 1A-C). Readings, performed on day (D) 2 and D4 according to International Contact Dermatitis Research Group criteria, showed a positive reaction to Traumalix DOLO gel 5% (D2++, D4+++) and Bepanthen Sensiderm (D2--, D4++) (Figure 1D). Traumalix DOLO gel 5% (D2++, D4+++) (Figure 1E). The individual ingredients of Bepanthen Sensiderm, kindly provided by the manufacturer in the same concentrations as found in Bepanthen Sensiderm, were subsequently patch-tested. They showed a positive reaction to Symcalmin, 5% solution of HPPBA in a vehicle of (1:1) butylene glycol and pentylene glycol (D2-, D4++) (Figure 1F), along with a negative reaction to both, dexpanthenol and pantolactone as well as to sodium benzoate 5% pet and benzyl alcohol 1% pet.
Chemical formulation of hydroxyphenyl propamidobenzoic acid (HPPBA; dihydroavenanthramide D). Symcalmin is a 5% solution of HPPBA in 1:1 butylene glycol and pentylene glycol
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HPPBA (Figure 2 ) could not be patch-tested separately.