FACIAL CONTACT DERMATITIS CAUSED BY PENCIL ERASERS

Abstract

<h3>Introduction</h3> Allergic contact dermatitis is a delayed type hypersensitivity reaction that can occur in previously sensitized individuals. While contact dermatitis prevalence in kids may be as high as 20-25%, the exact prevalence is unknown. Patch testing should be performed in patients concern for allergic contact dermatitis to determine the cause and prevent future reactions. <h3>Case Description</h3> A 16-year-old female with a history of eczema presents with a 2-year history of an intermittent itchy and flaky rash over her forehead and face. She initially was treated for seborrheic dermatitis without improvement. She denies changes in cosmetics or soaps. So far, fluocinolone oil and Vaseline seem to help the most, but nothing has prevented the rash from coming back. She was referred to allergy and T.R.U.E. test panel including 36 allergens was placed. At 96 hours, patch test showed 1+ reaction to mercapto mix. Upon discovering this sensitivity, patient recalls that when her rash started, she and her friends were using pencil erasers as earring backs. The erasers had irritated her ears, so she removed them, and the rash on her forehead coincidentally improved prior to patch testing. <h3>Discussion</h3> This case highlights the importance of patch testing even without a known exposure as an allergen must be identified and avoided to prevent recurrence of allergic contact dermatitis. Mercapto mix compounds are found in natural rubber, butyl rubber, nitrile, or neoprene products including gloves, athletic shoes, rubber-bands, erasers, and headphones. Allergy to mercapto mix is rare with most studies reporting <1% prevalence.