|Year : 1994 | Volume
| Issue : 1 | Page : 49-50
Photosensitivity to selsun shampoo
M Z Mani
Source of Support: None, Conflict of Interest: None
A case of photosensitive dermatitis, occurring after the second application of 2.5% selenium sulphide (Selsun shampoo, Abbot), is reported. The shampoo was diluted to half strength with water, before use. The patient had pityriasis versicolor, with extensive lesions on the covered as well as exposed areas.
Keywords: Selenium sulphide shampoo, Pityriasis versicolor, Photosensitive dermatitis
|How to cite this article:|
Mani M Z. Photosensitivity to selsun shampoo. Indian J Dermatol Venereol Leprol 1994;60:49-50
| Case Report|| |
A 21-year-old male student presented to our hospital on 3rd July 1978, with asymptomatic, hypopigmented macules on the neck, front of chest and upper back for 1 year. A diagnosis of pityriasis versicolor was made, and it was confirmed microscopically by examination of the scales in 10% potassium hydroxide.
The patient was advised to apply Selenium sulphide 2.5% in detergent base (Selsun shampoo, Abbot), after diluting it with an equal part of water. He was instructed to apply the diluted shampoo on alternate days in the morning, and to take a bath 24 hours after each application. The patient followed the instructions but used to apply two coatings each time, on the front of neck and chest, where the lesions were maximally present. After the second application, which was on the third day, the patient developed burning and erythema on the exposed lesions on the front of neck and chest and these symptoms were aggravated on sun exposure. There were no symptoms at all on the covered areas, where also the shampoo had been applied. There was no history of application of any oil or cosmetic.
On examination, there was erythema present only on the sunexposed areas of the neck and front of chest; whereas, the hypopigmented macules on the covered areas did not show any erythema. It was considered that the patient had developed a photosensitive dermatitis to selenium sulphide, and it was discontinued. The patient improved within seven days.
| Discussion|| |
It is known that administration of selenium compounds can cause photosensitivity. This is a property which selenium shares with certain other heavy metals.  Albright and Hitch  also, have mentioned that chronic selenium poisoning can produce a photosensitive eczematoid dermatitis. The later reference refers to the photosensitizing property of selenium sulphide, due to its systemic effect, and not to a photocontact dermatitis.
Selenium sulphide 2.5% is well known to produce contact dermatitis, probably due to an irritant effect. , At present, the recommended mode of application of selenium sulphide 2.5%, in the treatment of pityriasis versicolor, is a single application at bedtime, followed by a bath the next morning . , Albright and Hitch  have not mentioned why they adopted the time of application at night, in preference to the daytime. It may be conjectured that it was merely for convenience and not in order to avoid a possible photocontact dermatitis. Robinson and Yaffe  used 1% Selenium sulphide cream, twice daily for 2 weeks, in their series of 32 cases. They did not encounter a single case of either contact dermatitis or photocontact dermatitis. The concentration of selenium sulphide used by our patient was similar to that of Robinson and Yaffe (1% approximately, after dilution).
The author has known of several cases which developed an irritant dermatitis, with a single application of 2.5% selenium sulphide shampoo, applied at bedtime. Accordingly, a modified regimen has been followed in this hospital, by diluting the shampoo to half strength with water, and advising one application on alternate days for 2 weeks. No other case showing a photocontact dermatitis was encountered by the author. However, a similar case of photosensitivity due to undiluted selenium disulphide shampoo has been veported recently by Nair & Balachandran.  In our patient, it was more likely to have been photoallergic contact dermatitis rather than a phototoxic response, as this was the only case encountered, and also because the patient developed the reaction only after the second application, on the third day.
| Acknowledgement|| |
I am indebted to Dr L K Bhutani, MD, FAMS, FRC (Edin), Professor & Head of Dermatology and Venereology, AIIMS, New Delhi, for his suggestion regarding dilution of Selsun shampoo, as a modified form of treatment in pityriasis versicolor.
| References|| |
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|2.||Albright S D, Hitch J M. Rapid treatment of Tinea Versicolor with Selenium Sulfide. Arch Dermatol 1966; 93 : 460-2. |
|3.||Swinyard E A, Pathak M A. Surface acting drugs. In : The Pharmacological Basis of Therapeutics, (Goodman Gilman A, Goodman L S, Gilman A, eds), 6th edn. New York : Macmillan publishing Co, 1980; 951-63. |
|4.||Roberts S O B, MacKenzie D W R. Mycology. In : Text book of Dermatology, (Rook A,.Wilkinson D S, Ebling F J G, eds), 4th edn, Vol 1. Oxford : Blackwell Scientific Publications, 1979; 767. |
|5.||Robinson H M, Yaffe S N. Selenium sulphide in the treatment of Pityriasis Versicolor. J A M A 1956; 162: 113-4. |
|6.||Nair LV, Balachandran K. Photosensitive Dermatitis induced by Selenium Disulphide, Ind J Dermatol Venereol Leprol 1991; 57: 32-3. |