Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, VIC, Australia.
Melbourne Eastside Dermatology, Blackburn South, VIC, Australia.
Clin Exp Dermatol. 2022 Dec;47(12):2196-2200. doi: 10.1111/ced.15358. Epub 2022 Sep 26.
Hyperkeratotic flexural erythema (HKFE), also known as granular parakeratosis, is a scaly, erythematous or brown eruption, which usually occurs in the intertriginous and flexural areas. It has been linked to the use of benzalkonium chloride (BAK).
To review the clinical presentation of patients diagnosed with HKFE who had been exposed to laundry sanitizer containing BAK, and the therapies trialled to treat these patients.
This was a retrospective cases series of 45 patients seen by dermatologists in Victoria, Australia. Information was collected on clinical presentation, investigation and management.
The patients varied in age from 18 months to 89 years. The rash typically presented as a symmetrical erythema with characteristic multilayered brownish epidermal scaling. The most common location of the rash was the inguinal/anogenital area (32 of 45 patients; 71.1%) and there was a female predominance. Regarding treatment, topical corticosteroids were frequently prescribed and antibiotics were trialled in 11 patients; however, the condition resolved spontaneously over time in all patients with use of emollients, along with cleaning of the washing machine by running an empty wash, and repeated washing or sometimes disposal of BAK-contaminated clothing.
This large case series highlighted the characteristic clinical presentation of HKFE in the setting of BAK used in laundry sanitizer, demonstrating a potential causal link. Further studies are required to evaluate the role of the skin microbiome.
角化过度性褶皱红斑（HKFE），又称颗粒性角化不良，是一种鳞屑性、红斑性或棕色疹，通常发生于皱褶和弯曲部位。它与苯扎氯铵（BAK）的使用有关。
回顾曾接触含 BAK 的衣物消毒剂而被诊断为 HKFE 的患者的临床特征，以及这些患者接受的治疗方法。
这是澳大利亚维多利亚州皮肤科医生观察的 45 例患者的回顾性病例系列。收集了关于临床表现、检查和管理的信息。
患者年龄从 18 个月至 89 岁不等。皮疹表现为典型的对称红斑，具有特征性的多层棕色表皮鳞屑。皮疹最常见的部位是腹股沟/会阴部（45 例患者中的 32 例；71.1%），女性居多。关于治疗，经常开具外用皮质类固醇，11 例患者试用了抗生素；然而，所有患者都随着时间的推移通过使用保湿剂、清洗洗衣机（空洗一次）、反复清洗或有时丢弃含 BAK 的衣物，自行解决了问题。
本大型病例系列强调了 BAK 用于衣物消毒剂时 HKFE 的特征性临床特征，表明存在潜在的因果关系。需要进一步研究来评估皮肤微生物组的作用。
