Allergic contact dermatitis caused by an antiseptic containing cetrimide.

Antiseptic solutions are used to reduce the levels of pathogenic microorganisms on the skin prior to surgical interventions. Chlorhexidine is widely used for such purposes, as it is active against both gram-negative bacteria and yeast, but in particular against gram-positive bacteria. Chlorhexidine allergy, either immediate type I (1) or as delayed type IV allergic contact dermatitis reactions, is well known (2). Notably, in a French study evaluating patients suspected of having contact allergy to antiseptics, it was found that 18.7% of 75 patients were allergic to chlorhexidine (3). Cetrimide may be combined with chlorhexidine to enhance its action. Cetrimide, a mixture of different quaternary ammonium salts, of which the primary surfactant is cetrimonium bromide, is active against both gram-negative and gram-positive bacteria. In addition, it breaks down surface tension, permitting wetting of the surface, enabling disinfection