Revuz J, Poli F, Wechsler J, Dubertret L
Ann Dermatol Venereol. 1984;111(9):805-10.
Twenty patients with contact dermatitis to hexamidine, a commonly used antiseptic solution are reported. They have been collected during a 7 months period, thus suggesting that this contact allergy is not infrequent. Hydroalcoholic solution applied on epidermless skin is most frequently responsible for the contact dermatitis. Clinical features are very peculiar with papular semi-spheric and papulo-vesicular lesions being more frequently seen than classical vesicular eczema lesions. Due to this peculiar aspect, contact dermatitis to hexamidine is frequently misdiagnosed. The delay between onset and diagnosis has been sometimes longer than one year. It is four months as a mean. Pathologic aspect of these lesions is unusual too: dermal vasculitis either lymphocytic or with pycnotic polymorphonuclear is the most frequent aspect (14 out of 23 histological sections). Epidermal spongiosis is infrequent (5 cases). Contact dermatitis has usually a long standing evolution despite removal of the allergen and topical cortico-steroid treatment. Patch-test to hexamidine are frequently followed by a worsening of cutaneous lesions. One case of anaphylaxis following patch-testing has been reported. Clinical and pathological features of this contact dermatitis, suggests that humoral immune mechanisms play a key-role in its pathogenesis.
报告了20例对常用防腐剂溶液己脒产生接触性皮炎的患者。这些病例是在7个月内收集的，这表明这种接触性过敏并不罕见。涂于无表皮皮肤上的水醇溶液最常导致接触性皮炎。临床特征非常特殊，丘疹性半球形和丘疹水疱性损害比典型的水疱性湿疹损害更常见。由于这种特殊表现，己脒引起的接触性皮炎常被误诊。发病与诊断之间的间隔有时超过一年，平均为四个月。这些损害的病理表现也不寻常：最常见的是淋巴细胞性或核固缩多形核细胞性的真皮血管炎（23个组织切片中有14个）。表皮海绵形成不常见（5例）。尽管去除了过敏原并进行了局部皮质类固醇治疗，但接触性皮炎通常病程较长。对己脒进行斑贴试验后，皮肤损害常常会加重。有一例斑贴试验后发生过敏反应的报告。这种接触性皮炎的临床和病理特征表明，体液免疫机制在其发病机制中起关键作用。
