Irritant reactions to an antiseptic bath emollient

Abstract

BACKGROUND: Antiseptic bath emollients are important in the management of atopic eczema, helping to reduce the Staphylococcus aureus load and the frequency and severity of infective relapse. METHODS: We report seven cases who developed an irritant reaction to Oilatum Plus® (OP), an antiseptic bath emollient containing benzalkonium chloride (6%) and triclosan (2%). RESULTS: A typical feature is the lack of itch and patients often report only slight discomfort, in contrast with atopic eczema. Clinically, there is erythema, sometimes surmounted or surrounded by desquamation, often of an unusual brown colour. The most frequently involved areas are skin flexures and otherwise occluded skin, which may be explained by an increased penetration of the offending agent into the skin. In three cases, the reaction followed excessive or inappropriate use of OP bath emollient, but in other cases the reaction occurred even with apparently correct use of OP. CONCLUSION: Individual susceptibility to an irritant reaction from benzalkonium chloride and/or triclosan seems likely. The clinician should be aware of the potential for irritation from OP, and should advise patients on its correct use. (J Dermatol Treat (2000) 11: 263-267)