Department of Dermatology, Yidu Central Hospital of Weifang, Qingzhou, Weifang, Shandong Province, China.
Medicine (Baltimore). 2024 Aug 16;103(33):e39272. doi: 10.1097/MD.0000000000039272.
Systemic contact dermatitis (SCD) is an allergic inflammatory skin disease. We report that 3 family members developed SCD after exposing to laundry detergent containing benzalkonium chloride, which is rare. SCD caused by benzalkonium chloride has been reported. However, Similar symptoms in the whole family caused by it have not been reported yet. In our case, a 36-year-old man was diagnosed as SCD, and his symptoms had not controlled after 7 days treatment, until he stopped dressing the clothes washed by the laundry detergent containing benzalkonium chloride. It was interesting that both his wife and the daughter developed SCD successively, and they have not exposed to any haptens besides the benzalkonium chloride in the laundry detergent.
Dermoscopic examination showed bright-red background, focal branching vessels and white scales. HE staining from the lesion revealed hyperkeratosis and parakeratosis, focal subcorneal microabscess, ocal hyperkeratosis, koilocyte in the epidermis, and erythrocyte extravasation, fibroplasia, hyaline degeneration and scattered aggregates of lymphocytes in the dermis. Then path test was performed 1 month after recovery with benzalkonium chloride 0.05% and 0.1% in petrolatum.
Stop the laundry detergent containing benzalkonium chloride. The symptoms had controlled after they stopped the laundry detergent containing benzalkonium chloride.
The case highlights that benzalkonium chloride with very low concentration and repeated exposure may be an active agent of SCD. It is of the utmost importance to pay close attention to patients presenting with similar symptoms within the family. A thorough examination of the medical history is essential to determine the underlying cause.
系统性接触性皮炎（SCD）是一种过敏性炎症性皮肤病。我们报告了 3 名家庭成员在接触含苯扎氯铵的洗衣液后发生 SCD，这很少见。已有报道称 SCD 是由苯扎氯铵引起的。然而，尚未报道过由其引起的整个家族中出现类似症状的情况。在我们的病例中，一名 36 岁男性被诊断为 SCD，他在接受 7 天治疗后症状仍未得到控制，直到他停止穿着含苯扎氯铵的洗衣液洗涤的衣物。有趣的是，他的妻子和女儿相继患上了 SCD，除了洗衣液中的苯扎氯铵之外，她们没有接触任何半抗原。
皮肤镜检查显示背景呈鲜红色，局灶性分支血管和白色鳞屑。病变处的 HE 染色显示角化过度和角化不全、局灶性表皮下微脓肿、局灶性角化过度、表皮中的空泡细胞和红细胞渗出、纤维增生、透明变性和散在聚集的淋巴细胞。然后在恢复后 1 个月用苯扎氯铵 0.05%和 0.1%在凡士林中进行斑贴试验。
停止使用含苯扎氯铵的洗衣液。停止使用含苯扎氯铵的洗衣液后，症状得到控制。
该病例强调了极低浓度的苯扎氯铵和重复暴露可能是 SCD 的活性物质。对于家族中出现类似症状的患者，应密切关注，非常重要。彻底检查病史对于确定潜在病因至关重要。
