This case series reviewed adults with hand eczema linked to moist towelettes used for diaper hygiene or personal care. Nine adults, six women and three men, had a compatible exposure, a relevant positive patch test, and improvement after avoidance. The eruption was often on the thumb and two adjacent fingers used to hold the towelette. Five patients were applying the product to an infant, and the authors report that no infant was affected. The attributed allergens are preservatives and, in several patients, fragrance. No heavy-metal concentration is reported.
Key numbers
This source does not report a heavy-metal concentration, a metal release value, or a metal limit of its own.
Methods (brief)
Records from 1991-1997 at an academic practice and the last three years of a private practice were searched for wipe exposure. Patients with exposure but no compatible eruption were excluded. Patch tests covered a standard series that grew from 30 to 41 antigens, plus personal products. Some known cases were called to confirm exposure and outcome.
Evidence fitness
A clinical pattern of hand eczema in adults who held moist towelettes, with relevant preservative and often fragrance allergy, improving after avoidance.
They do not support Any heavy-metal concentration in wipes or other products; A population percent positive to nickel, chromium, or cobalt. One adult (patient 2) has a 3+ grade to nickel sulfate 5% petrolatum. That grade is one person’s patch-test score, not a sensitization rate and not a product concentration; Disease in the infants. The authors state they had not seen an affected infant.
Limitations
Nine selected adults, not a rate in a defined population. Several patients had multiple contact allergies, including corticosteroids, so the wipe was not the only exposure. Wipe brands are not named. Patch tests of the wipes as is were not done for most patients (printed as ND).
Related evidence
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