Allergic paraben and benzyl alcohol hypersensitivity relationship of the "delayed" and "immediate" varieties. 1975

A A Fisher

From a review of the literature, and the results of scratch, intracutaneous and subcutaneous injections of patients with parbens and benzyl alcohol sensitivity of the delayed type characterized by allergic contact dermatitis and strongly positive patch patch tests, it would appear that such sensitivity is not usually accompanied by the immediate urticarial type of allergic sensitivity. This communication concerns itself with results of testing patients with clinical sensitivity and positive patch test reactions to the parabens or benzyl alcohol with scratch, intracutaneous and subcutaneous injections of these preservatives in order to determine the relationship of the "delayed" type of allergic hypersensitivity to the parabens and benzyl alcohol with the "immediate" variety of hypersensitivity. The parabens and benzyl alcohol are widely employed as preservatives for many allergenic extracts used in scratch and intracutaneous testing. In addition, these preservatives are used in injectable corticosteroid medicaments and in local anesthetic solutions. In order to determine whether the presence of these preservatives in allergenic extracts would produce false positive scratch or intracutaneous tests or might produce an immediate, urticarial or anaphylactic reaction in patients with allergic contact dermatitis and positive patch test reactions to these preservatives, two patients with positive patch test reactions and allergic contact dermatitis to the parabens and two with similar benzyl alcohol sensitivity were tested in the manner detailed in the following case reports.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D006969 Hypersensitivity, Immediate Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigen-antibody reaction and causes smooth muscle contraction and increased vascular permeability. Atopic Hypersensitivity,Hypersensitivity, Atopic,Hypersensitivity, Type I,IgE-Mediated Hypersensitivity,Type I Hypersensitivity,Atopic Hypersensitivities,Hypersensitivities, Atopic,Hypersensitivities, IgE-Mediated,Hypersensitivities, Immediate,Hypersensitivities, Type I,Hypersensitivity, IgE-Mediated,IgE Mediated Hypersensitivity,IgE-Mediated Hypersensitivities,Immediate Hypersensitivities,Immediate Hypersensitivity,Type I Hypersensitivities
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009824 Ointments Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. Ointment,Paste,Pastes,Salve,Unguent,Salves,Skin Ointment,Unguents,Ointment, Skin
D010226 Parabens Methyl, propyl, butyl, and ethyl esters of p-hydroxybenzoic acid. They have been approved by the FDA as antimicrobial agents for foods and pharmaceuticals. (From Hawley's Condensed Chemical Dictionary, 11th ed, p872) 4-Hydroxybenzoic Acids,Paraben,para-Hydroxybenzoic Acids,4 Hydroxybenzoic Acids,para Hydroxybenzoic Acids
D010328 Patch Tests Skin tests in which the sensitizer is applied to a patch of cotton cloth or gauze held in place for approximately 48-72 hours. It is used for the elicitation of a contact hypersensitivity reaction. Patch Testing,Patch Test,Patch Testings,Test, Patch,Testing, Patch,Testings, Patch,Tests, Patch
D003875 Drug Eruptions Adverse cutaneous reactions caused by ingestion, parenteral use, or local application of a drug. These may assume various morphologic patterns and produce various types of lesions. Dermatitis Medicamentosa,Dermatitis, Adverse Drug Reaction,Maculopapular Drug Eruption,Maculopapular Exanthem,Morbilliform Drug Reaction,Morbilliform Exanthem,Drug Eruption,Drug Eruption, Maculopapular,Drug Eruptions, Maculopapular,Drug Reaction, Morbilliform,Drug Reactions, Morbilliform,Eruption, Drug,Eruption, Maculopapular Drug,Eruptions, Drug,Eruptions, Maculopapular Drug,Exanthem, Maculopapular,Exanthem, Morbilliform,Exanthems, Maculopapular,Exanthems, Morbilliform,Maculopapular Drug Eruptions,Maculopapular Exanthems,Morbilliform Drug Reactions,Morbilliform Exanthems,Reaction, Morbilliform Drug,Reactions, Morbilliform Drug
D003877 Dermatitis, Contact A type of acute or chronic skin reaction in which sensitivity is manifested by reactivity to materials or substances coming in contact with the skin. It may involve allergic or non-allergic mechanisms. Contact Dermatitis,Dermatitis Venenata,Eczema, Contact,Hypersensitivity, Contact,Sensitivity, Contact,Contact Dermatitides,Contact Eczema,Contact Hypersensitivities,Contact Hypersensitivity,Contact Sensitivities,Contact Sensitivity,Dermatitides, Contact,Hypersensitivities, Contact,Sensitivities, Contact
D005260 Female Females

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