Allergic contact dermatitis caused by topical antiacne drugs

Abstract

Acne is a chronic inflammatory disease for which a long-lasting therapy, very often with topical drugs, is necessary. Despite the fact that several topical antiacne drugs (in particular, tretinoin, benzoyl peroxide, clindamycin and erythromycin) are used for many years, often on broad skin surfaces and for long periods of time, their potential for contact sensitization is low. Their potential for phototoxic and photoallergic reactions is also low. Much more frequent is irritant contact dermatitis caused by some of these drugs, in particular, retinoids and benzoyl peroxide, for which the short contact therapy has been recently suggested.

Keywords:

• acne
• allergic contact dermatitis
• benzoyl peroxide
• clindamycin
• erythromycin
• irritant contact dermatitis
• retinoids
• short contact therapy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Potential for contact sensitization of several topical antiacne drugs (tretinoin, clindamycin and erythromycin) is low.

• It is possible that cases diagnosed as allergic contact dermatitis (ACD) caused by tretinoin actually are cases of irritant contact dermatitis.

• Irritant contact dermatitis caused by some of these antiacne drugs, in particular, retinoids and benzoyl peroxide, is much more frequent than ACD.

• Although literature data on ACD caused by benzoyl peroxide are conflicting, it is possible that the incidence of ACD is underestimated.

• Potential for phototoxic and photoallergic reactions caused by topical antiacne drugs is low.

• The short contact therapy has been recently suggested in order to try to reduce the incidence and severity of retinoid dermatitis.

• The efficacy of tretinoin used as short contact therapy is superimposable on that of tretinoin used according to standard modality.