OCCUPATIONAL CONTACT-DERMATITIS TO PROPACETAMOL - ALLERGOLOGICAL AND CHEMICAL INVESTIGATIONS IN 2 NEW CASES

Background and Objective: In 2 new cases of occupational contact derma titis due to a recently described allergen (propacetamol), a prodrug w hich is a soluble diethylglycidyl ester of paracetamol, an allergologi cal investigation was performed to elucidate the nature of the allerge n involved in the propacetamol contact sensitivity. Observations: Two nurses with eczema of the hands and face had positive patch tests to P ro-Dafalgan(R). Every day the nurses prepared injections of Pro-Dafalg an(R) (propacetamol dissolved in sodium citrate). The sensitization wa s due to propacetamol and not to the solvent, To elucidate which part of propacetamol was responsible for the sensitization, the 2 nurses we re patch-tested with diethylamine, paracetamol (diluted in different v ehicles) and some of their chemical analogues and potential impurities which were all negative. Conclusions: Propacetamol induces airborne c ontact dermatitis with no evidence of sensitization to paracetamol or diethylglycine, possibly because of either the presence of unknown imp urities and/or an antigenic structure related to the covalent bond of the prodrug.