Phenylephrine is a frequent cause of periorbital allergic contact dermatitis.

Abstract

Phenylephrine is a selective α1-adrenergic receptor agonist used in eye drops, in order to dilate the pupil to facilitate visualization of the retina, and also to treat nasal congestion and increased sinus pressure resulting from rhinitis. However, in Denmark it is only marketed as mydriatic eye drops. Phenylephrine hydrochloride (HCl) is a well-known contact allergen. The Allergen Bank is a service established in 1992 for dermatologists in practice in Denmark, where, on a subscription basis, they can gain access to extra contact allergens, for example phenylephrine HCl, as supplements to the baseline series for case-by-case testing of individual patients (1). Phenylephrine HCl has been available from the Allergen Bank since 2000. We performed a retrospective analysis of patients patch tested with phenylephrine HCl from 2000 to 2014 both in private dermatological practices and in a department of dermatology. The vast majority of patients tested at the dermatology department were referred by the ophthalmologist because of acute periorbital dermatitis and suspected allergic contact dermatitis caused by eye drops. We assume that the same referral mechanism was in effect in dermatological practice; however, detailed information is not available.