Contact dermatitis due to PPI
In an occupational airborne contact dermatitis (CD) due to PPI, the
erythematous lesions of the face predominating on eyelids led to
vitiligo lesions85, patch tests were positive with the
handled PPI (pantoprazole and rabeprazole).85 In the
literature, 10 cases of occupational CD due to PPI have been reported in
workers in pharmaceutical industry or in horse
trainers.86 In all cases it was an airborne eczema
predominating on the face, mainly on the eyelids, the neck, arms and
hands. Patch tests have proven to be a useful diagnostic tool frequently
with strong positive results even with low concentrations. Therefore, as
in these peculiar cases, it is possible to obtain the PPI pure in powder
and we recommend to begin with patch tests at not more than 1% in
petrolatum, then, if negative, at 10% in petrolatum. Multiple
sensitizations to different subclasses are possible and might be due to
cross-reactivity or, more likely, to multiple exposures to different
PPI.