Occupational Airborne Contact Dermatitis by Isothiazolinones Contained in Wall Paint Products

摘要

Isothiazolinone includes 5-chloro-2-methyl-4-isothiazolin-3-one (MCI; Fig. 1a), 2-methyl-4-isothiazolin-3-one (MI; Fig. 1b), Kathon? CG (MCI MI) and 1,2-benzisothiazolin-3-one (BIT; Fig. 1c).1,2 Occupationalcontact dermatitis due to isothiazolinone has beenoften reported and discussed in Europe, 3 howeversuch cases was not much reported in Japan and notyet widely recognized by Japanese tradesperson. Recently, the cases of isothiazolinone related dermatitisin Japan was reported in 2010,4 which is about nonoccupational allergic contact dermatitis from isothiazolinone preservative in a Japanese mattress gelsheet used for cooling and it made big impact onthose customers. Although mattress gel-sheet gathered attention, isothiazolinone is included in variousother products and especially tradesperson should beaware that there might be a risk of contact dermatitisfrom it. More important point is that contact dermatitis by isothiazolinone can occur even from aeriallysprayed materials.5 Then, here we report a case of occupational airborne contact dermatitis by isothiazolinone in wall paint products to reaffirm such an occupational problem.A 66-year-old man, who worked as a house painter,developed painful and pruritic eczema on the eyelids,neck, hands, fingers, arms and trunk (Fig. 1d-f), twoyears after he started using a particular kind of paint.He also had pain in the nasal mucosa, oral mucosaand the eyes. He was wearing short sleeves and cotton gloves while spraying the above-mentioned painton walls. His symptom improved when he stopped using the paint for a while. He had no history of atopicdermatitis or other skin diseases. Eczema appearedboth on exposed and unexposed areas. He had neverdirectly touched the paint. The patient commencedtopical glucocorticosteroids and his symptom gradually improved after using goggles, protective maskand gloves. After the rash improved and he stoppedusing glucocorticosteroids to the trunk, patch testwas planned. We did not prepare healthy controls forthe patch test.