2,4-Dichloro-5-methylpyrimidine-induced irritant contact dermatitis: 64 case reports

Abstract

Objective To investigate clinical features and treatment of, as well as protective measures against 2,4-dichloro-5-methylpyrimidine (DCP) - induced contact dermatitis. Methods Clinical data were collected from 64 patients with DCP-induced contact dermatitis, and analyzed retrospectively. Analytical results were used to improve protective measures in workplaces. Results Irritant contact dermatitis occurred 1-12 minutes (mean, 7 minutes) after contact with DCP in all the patients. Lesions appeared at sites of contact with DCP, and mainly manifested as swelling erythema with sharp boundaries. Lesion areas varied from 58 to 5 600 cm2. Ten patients presented with blisters, 48 with burning pain, 16 with itching, 4 with headache, 3 with nausea and vomiting, and 1 with fainting. Pruritic lesions appeared at non-contact sites in 10 patients 1 - 4 days after avoidance of contact with DCP. Histopathologic examination showed intercellular and intracellular edema and spongiosis in the epidermis in 8 patients, intraepidermal blisters in 5 patients, papillary dermal edema and inflammatory cell infiltration in 7 patients. Glucocorticoids were effective for the treatment of DCP-induced contact dermatitis. Positive pressure-inflated protective clothing could absolutely isolate workers from outside environment to avoid the occurrence of DCP- induced contact dermatitis. Conclusions DCP-induced contact dermatitis is a kind of irritant contact dermatitis. Delayed hypersensitivity reactions occur in a few patients after contact with DCP. Positive pressure-inflated protective clothing is effective for the protection from DCP-induced contact dermatitis. Key words: Dermatitis, irritant; Dermatitis, contact; Protective clothing; Clinical protocols; 2,4-Dichloro-5-methylpyrimidine