Ungewöhnlich starkes allergisches Kontaktekzem auf Inhaltsstoffe einer schwarzen Lederbörse

Abstract

We report about a 51-year-old man presented to our outpatient department with infiltrated, oozing and crusting erythema, papulovesicles and tiny scattering eczematous lesions on his buttocks that had begun a few days ago. In the course of treatment he developed similar skin lesions on his thigh and his chest. After a few weeks of treatment he told us that skin lesions started a few days after he had become a new black leather purse and a matching key case. Patch testing revealed strong positive reactions to nickel and to the patients purse and key case (leather inside and outside and the metal label). The dimethylglyxim test showed nickel in the metal label and in other metal components of the purse and the key case. However, no nickel was detected in the leather. After allergen avoidance and transient treatment with local steroids our patient resolved quickly. Due to the severe contact dermatitis in spite of no direct skin contact (the patient wore clothes) the possibility of an additional sensitization to ingredients of the black purse, e.g. leather dyes or tannins that were not included in the commercially available patch test series should be considered.