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CASE REPORT
Year : 1991  |  Volume : 57  |  Issue : 5  |  Page : 235-236

Contact dermatitis due to minoxidil




Correspondence Address:
J S Pasricha


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Source of Support: None, Conflict of Interest: None


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  Abstract 

A 25-year old girl having androgenetic alopecia developed itching and erythema on the scalp one month after she started applying a commercial preparation containing 2% minoxidil. The dermatitis disappeared on discontinuing minoxidil but recurred when she applied minoxidil again after a gap of 1 month. Patch tests revealed a papulo-vesicular reaction with the commercial minoxidil lotion and also with a minoxidil tablet powdered and made into a paste with distilled water. Patch tests with ethyl alcohol were negative.


Keywords: Contact dermatitis, Minoxidil


How to cite this article:
Pasricha J S, Nanda A, Bajaj N. Contact dermatitis due to minoxidil. Indian J Dermatol Venereol Leprol 1991;57:235-6

How to cite this URL:
Pasricha J S, Nanda A, Bajaj N. Contact dermatitis due to minoxidil. Indian J Dermatol Venereol Leprol [serial online] 1991 [cited 2019 Aug 18];57:235-6. Available from: http://www.ijdvl.com/text.asp?1991/57/5/235/3691


Topical minoxidil was first used for alopecia areata in 1981[1],[2] and subsequently for androgenetic alopecia as well.[3],[4],[5],[6] It is a fairly safe drug[3],[4],[5],[6] except that a proportion of the topically applied drug gets absorbed through the skin and if the quantity of the drug applied is more, it can cause headache in the patient. This headache is dose depen­dent and disappears if the quantity of the drug applied on the skin is reduced. The other side effects include a mild irritant dermatitis and increased hair growth in re­gions outside the area of drug application. Contact dermatitis due to minoxidil has been reported in eight cases.[2],[7],[8],[9],[10] All these cases were confirmed by positive patch test reac­tions with minoxidil. One patient of Tosti et al[9] had photoallergic contact dermatitis.

In India, topical minoxidil was first intro­duced in 1988, but contact dermatitis due to minoxidil has not been reported so far. We are reporting, the first Indian case of contact dermatitis due to this drug confirmed by patch tests.


  Case Report Top


One and half years ago, a 25-year-old girl started having diffuse loss of hair from the fronto-parietal areas of her scalp for which in August 1990, she started applying a commer­cial hair lotion containing 2% minoxidil in an alcoholic base. One month after the start of the treatment, she noticed itching and erythema in the corresponding areas of the scalp, and this became worse with further applications. A general practitioner advised her to stop further applications of minoxidil and prescribed betamethasone 17-valerate topically and anti­histamines orally. The lesions subsided in 3 days. One month later, the patient applied the minoxidil lotion once again and developed dermatitis within 3 hours, but the same treat­ment again led to regression of the dermatitis.

In may 1991, she consulted us for advice regarding her hair loss. She had no recurrence of dermatitis ever since she stopped applying minoxidil. A standard occluded patch test with the commercial minoxidil lotion showed a se­vere papulo-vesicular reaction. A similar re­action was obtained with the commercial minoxidil lotion used in the specialised cup designed by us for testing volatile substances. A milder reaction was obtained in the patch test undertaken with a tablet of minoxidil powdered and wetted with distilled water. Patch tests with ethyl alcohol were negative.


  Comments Top


Excessive applications of minoxidil lotion can sometimes cause non-specific irritant re­actions, but contact dermatitis should be sus­pected if the patient reacts to normal or even smaller quantities of the drug. It is also nec­essary to exclude the possibility of contact hypersensitivity to some other constituent of the commercial solution rather than minoxidil itself. The commercial minoxidil solution con­tains propylene glycol and ethyl alcohol as a base for minoxidil and at least 4 patients have been recorded who were actually allergic to propylene glycol rather than minoxidil.[7],[10],[11] Contact hypersensitivity to alcohol is also well documented[12] Positive patch tests in our pa­tient with the powdered tablet of minoxidil leave no doubt that our patient had contact hypersensitivity to minoxidil itself and not any other ingredient.

 
  References Top

1.Weiss VC, West DP and Mueller CE: Topical minoxidil in alopecia areata, J Amer Acad Dermatol, 1981; 5:224-226.  Back to cited text no. 1    
2.Weiss VC, West DP, Fu TS et al: Alopecia areata treated with topical minoxidil, Arch Dermatol, 1984; 120:457-463.  Back to cited text no. 2    
3.De Villez RL: Topical minoxidil therapy in heredi­tary androgenetic alopecia, Arch Dermatol, 1985; 121:197-202.  Back to cited text no. 3    
4.Katz HI, Hien NT, Prawer SE et al: Long-term ef­ficacy of topical minoxidil in male pattern baldness, J Amer Acad Dermatol, 1987; 16:711-718.  Back to cited text no. 4    
5.Rietschel RL and Duncan JH: Safety and efficacy of topical minoxidil in the management of androge­netic alopecia, J Amer Acad Dermatol, 1987; 16:677-685.  Back to cited text no. 5    
6.De Villez RL: The therapeutic use of topical minoxidil, Dermatol Clin, 1990; 8:367-375.  Back to cited text no. 6    
7.Degreef H, Hendricks 1 and Dooms-Goossens A: Allergic contact dermatitis to minoxidil, Contact Dermatitis, 1985; 13:194.  Back to cited text no. 7    
8.Fiedler-Weiss VC, West DP, Buys CM et al: Topi­cal minoxidil dose-response effect in a alopecia areata, Arch Dermatol, 1986; 122:180-182.  Back to cited text no. 8    
9.Tosti A, Bardazzi F, De Padova MP et al: Contact dermatitis to minoxidil, Contact Dermatitis, 1986; 13:275-276.  Back to cited text no. 9    
10.Van der Willigen AH, Dutree-Meulenberg ROGM, Stolz E et al: Topical minoxidil sensitization in an­drogenic alopecia, Contact Dermatitis, 1987; 17:44-45.  Back to cited text no. 10    
11.Fisher AA: Use of glycerin in topical minoxidil so­lutions for patients allergic to propylene glycol, Cutis, 1990; 45:81-82.  Back to cited text no. 11    
12.Pasricha JS and Verma KK : Contact dermatitis caused by ethyl alcohol, Ind J Dermatol Venereol Leprol, 1990; 56:328-329.  Back to cited text no. 12    




 

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