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Contact allergy to sorbic acid and Unguentum Merck

Only a few cases of sorbic acid sensitivity resulting from the use of Unguentum Merck (E. Merck Ltd.) are described in the literature (Saihan & Harman 1978, Brown 1979, Coyle et al. 1981). At the Department of Dermatology, University of Umea, Unguentum Merck has often been prescribed since its introduction in Sweden in 1973. Prescriptions of carbamide (urea) 10% in Unguentum Merck as emollients have also been given as well as the topical steroid Corticoderm Cream (E. Merck Ltd.), which also contains Unguentum Merck. Due to therapy failure or worsening of existing eczema a large number of patients have been patch tested to known contact allergens in topical medicaments and to the actual medicament itself. From 1973 to 1980 we have observed 25 cases of contact allergy to sorbic acid (test concentration 2.5% in 95% ale.) and/or to Unguentum Merck or carbamidc-Unguentum Merck (50% in petrolatum). 21 patients were patch tested to sorbic acid; 19 were positive, 2 were negative. The 2 patients with a negative test reaction to sorbic acid were positive to carbamide-Unguentum Merck, and one of them was also positive to the perfume in Unguentum Merck. The 4 patients not tested to sorbic acid had a positive patch test reaction to Unguentum Merck (2 cases) and to carbamide-Unguentum Merck (2 cases). In 20 of these 25 cases the test reaction had a clinical relevance, i.e. the patient's eczema had been aggravated by treatment with Unguentum Merck, carbamide-Unguentum and/or Corticoderm Cream and the dermatitis cleared up when the topical therapy was changed. Thus, it has been demonstrated that Unguentum Merck causes a rather high frequency of contact sensitivity.