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Generalized allergic contact dermatitis caused by methylisothiazolinone in a spray tan

A 49-year-old healthy woman with previously documented nickel allergy developed acute dermatitis of the face, neck and upper and lower limbs 2 days after using CT Color Perfecting ComplexTM (California Tan®, Indianapolis, IN, USA) all over her body (Fig. 1). The spray tan contained dihydroxyacetone, and was preserved with methylisothiazolinone and methylchloroisothiazolinone. Treatment included systemic prednisolone and topical hydrocortisone-17-butyrate. The patient had used similar spray tan products on her legs a couple of times before, but had never experienced dermatitis. However, 2months prior to the current spray tan exposure, she noticed face dermatitis after using Clarins ParisTM creme (95300 Pontoise, France). Patch testing with the European baseline series [TRUE Test® panel 1–3 (SmartPractice, Hillerod, Denmark) supplemented with the remaining baseline allergens], Clarins ParisTM creme ‘as is’ and the spray tan ‘as is’ in Finn Chambers® on Scanpor® tape (SmartPractice) was performed according to the department’s