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.