Occupational allergic contact dermatitis from alkylammonium amidobenzoate

Quaternary ammonium compounds are water-soluble antimicrobials which are wi dely used in disinfectants, sterilizers, skin cleansers and antiseptic crea ms, One quaternary ammonium compound, alkylammonium amidobenzoate (Osmaron B (R)) has for decades been used in udder ointments. Here we present a ship technician with occupationally induced sensitization to alkylammonium amid obenzoate. The diagnosis was reached only when it emerged, after careful qu estioning, that the patient was exposed to a substance peculiar to his work place but not to his occupation and was then patch tested for it. It turned out that an udder ointment had been used at the patient's workplace as a h and ointment. Patch testing was positive to the patient's hand ointment, an d Osmaron B (R) at 0.1-0.01% in petrolatum. Other sensitizing quaternary am monium compounds, namely benzalkonium chloride, benzethonium chloride, benz oxonium chloride, N-benzyl-N,N-dihydroxyethyl-N-cocosalkyl-ammonium chlorid e, cetalkonium chloride, cetylpyridinium chloride, cetrimonium bromide, chl oroallylhexaminium chloride, dequalinium chloride, domiphen bromide, methyl benzethonium chloride and 2,3-epoxypropyl trimethyl ammonium chloride are r eviewed briefly. The importance of patch testing to all materials in use by the patient is emphasized. It is also important to select non-allergenic h and creams for use at work places.