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Allergic contact dermatitis from cetyl alcohol.

Angela E. Aakhus, BS, Department of Dermatology, University of Minnesota School of Medicine, Minneapolis, MN; Erin M. Warshaw, MD, MS, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN Background: Cetyl alcohol is a widely used emulsifier and a rare cause of contact allergy. We present two cases of allergic contact dermatitis to cetyl alcohol. Cases: The first patient was a 62-year-old woman with a long history of hand dermatitis that had significantly worsened over the previous two years. Despite avoidance of allergens discovered on initial patch testing, her dermatitis persisted. Repeat patch testing revealed sensitivity to cetyl alcohol, which was found to be present in many of her products, including her Vanicream moisturizer, Cetaphil cleanser, and Vaseline Creamy Deep Moisturizer. The second patient was a 61-year-old female with dermatitis surrounding a chronic ulcer on her right ankle. She had been applying multiple products to the ulcer, including mupirocin ointment, Zonalon cream, Benadryl Extra-Strength Itch-Stopping cream, and Vanicream moisturizer. Patch testing revealed sensitivities to the Zonalon cream, cetyl alcohol, and the Benadryl cream ‘‘as is.’’ Cetyl alcohol was present in the Zonalon cream, Benadryl cream, Vanicream moisturizer, and multiple other moisturizers used by the patient. Summary: Although rare, allergy to cetyl alcohol must be considered in patients who suffer continued dermatitis despite the use of hypoallergenic products and topical medications. The presence of cetyl alcohol in many hypoallergenic products makes diagnosis and management challenging.