Skin Rashes in Children Linked to Preservative in Wet Wipes
A preservative used in some popular wet wipes may be leading to significant eczematous dermatitis in children, according to a case report published online January 13 in Pediatrics. Physicians may be misdiagnosing these cases as other skin disorders.
Mary Wu Chang, MD, from the Department of Dermatology and the Department of Pediatrics, and medical student Radhika Nakrani, BS, from the University of Connecticut School of Medicine, Farmington, report that 6 children have presented with "chronic, recalcitrant perianal and/or facial dermatitis" after the use of 2 brands (Cottonelle and Huggie) of wet wipes. The problems resolved quickly and completely after use of the wipes stopped.
This is the first US report of pediatric allergic contact dermatitis linked to methylisothiazolinone (MI), a preservative in wet wipes. One case also has been reported in Belgium. Wet wipes are "extensively tested and traditionally believed to be innocuous," the authors write.
The authors describe a case of an 8-year-old girl who had a "6-week history of eczematous, excoriated, crusted, and weeping plagues on the cheeks and around the mouth." She had previously been misdiagnosed with impetiginized eczema, and numerous oral and topical medications failed to relieve the problem.
In talking with the child's mother, the authors learned that the child had been using wet wipes after toileting and for facial cleansing, and they advised the mother to discontinue that practice. The mother, instead, switched brands, and the problem continued.
"After discontinuing all use of wipes, the patient's rash completely and rapidly resolved, and did not recur," the authors write.
They also diagnosed allergic contact dermatitis to MI in 5 other children who presented with chronic erythematous, eczematous, and pruritic patches and plaques in the perianal/buttock area or around the mouth after using wet wipes containing MI. Those children also experienced rapid resolution of symptoms after discontinuing use of the wipes.
The authors confirmed all cases with standard patch testing with low MI concentrations.
"As wet wipes are being increasingly marketed as personal care products for all ages, MI exposure and contact sensitization will likely increase," the authors write. "Dermatitis of the perianal, facial, and hand areas with a history of wet wipe use should raise suspicion of [allergic contact dermatitis ] to MI and prompt appropriate patch testing."