Kanerva L, Estlander T, Jolanki R
Section of Dermatology, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland.
Eur J Dermatol. 2001 May-Jun;11(3):240-3.
Quaternary ammonium compounds are water-soluble antimicrobials which are widely used in disinfectants, sterilizers, skin cleansers and antiseptic creams. One quaternary ammonium compound, alkylammonium amidobenzoate (Osmaron B) has for decades been used in udder ointments. Here we present a ship technician with occupationally induced sensitization to alkylammonium amidobenzoate. The diagnosis was reached only when it emerged, after careful questioning, that the patient was exposed to a substance peculiar to his workplace 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 hand ointment. Patch testing was positive to the patient's hand ointment, and Osmaron B at 0.1-0.01% in petrolatum. Other sensitizing quaternary ammonium compounds, namely benzalkonium chloride, benzethonium chloride, benzoxonium chloride, N-benzyl-N,N-dihydroxyethyl-N-cocosalkyl-ammonium chloride, cetalkonium chloride, cetylpyridinium chloride, cetrimonium bromide, chloroallylhexaminium chloride, dequalinium chloride, domiphen bromide, methylbenzethonium chloride and 2,3-epoxypropyl trimethyl ammonium chloride are reviewed briefly. The importance of patch testing to all materials in use by the patient is emphasized. It is also important to select non-allergenic hand creams for use at work places.
季铵化合物是水溶性抗菌剂，广泛用于消毒剂、灭菌剂、皮肤清洁剂和抗菌乳膏中。一种季铵化合物，烷基铵氨基苯甲酸盐（Osmaron B）已在乳房软膏中使用了数十年。在此，我们介绍一名对烷基铵氨基苯甲酸盐产生职业性致敏的船舶技术员。只有在仔细询问后发现患者接触了其工作场所特有的一种物质而非其职业特有的物质，然后对其进行斑贴试验后，才得出诊断结果。结果发现，患者工作场所将一种乳房软膏用作护手霜。患者的护手霜斑贴试验呈阳性，凡士林基质中0.1 - 0.01%的Osmaron B斑贴试验也呈阳性。还简要回顾了其他致敏性季铵化合物，即苯扎氯铵、苄索氯铵、苯氧氯铵、N - 苄基 - N,N - 二羟乙基 - N - 椰油烷基氯化铵、西他氯铵、西吡氯铵、西曲溴铵、氯烯丙基六甲铵、地喹氯铵、度米芬、甲基苄索氯铵和2,3 - 环氧丙基三甲基氯化铵。强调了对患者使用的所有材料进行斑贴试验的重要性。在工作场所选择无致敏性的护手霜也很重要。
