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Allergic contact dermatitis from 2‐bromo‐2‐nitropropane‐1,3‐diol in Metrogel®

A 59-year-old-woman with an 8-year history of rosacea presented with a florid eczema of the face, particularly the forehead, and upper eyelids. There was also a diffuse eczema on the base of the neck anteriorly but the rest of her skin was clear. Her rosacea had previously been treated with oxytetracycline and dietary restriction with good response, but recently there had been no such response. Her current treatment was topical metronidazole gel (MetrogelA) and aqueous cream. Patch testing was performed to the European standard series, a face series, hair dye and an acrylics series, plus her own nail glue and cosmetics. A (π π) reaction to 2-bromo-2-nitropropane, 1–3-diol was seen at D4. A (π) reaction at the site of an open patch test was seen to her own nail glue (a cyanoacrylate). She was treated successfully with topical corticosteroids, stopping the metronidazole gel and discontinuing the use of artificial nails.