Navarro Gracia B. Alarcón Gallardo E, Claver Monzón A, Peña-Peloche M, Botey Faraudo E, Cisteró-Bahima A.
Hospital Universitari Quiron Dexeus. UAB, AlergiaDexeus, Barcelona, Spain

Allergic contact dermatitis to textile dyes is considered to be a rare phenomenon. Allergy prevalence to disperse dyes round between 0.4 and 6.7%

Method: A 32-year-old female, with no allergy clinical records, was referred to our Center. She suffered itching lesions coinciding with swimsuit area within 3 hours after outdoor swimming. The patient dressed a new orange bikini and did not use sunscreen protection. No previous problems with other clothes were referred, whatever its colour.

Clinical examination disclosed erythematous-desquamative lesions located on buttocks and mammary area, just drawing the bikini. Oral antihistaminic and topic corticosteroids treatment were successfully administered.

Patch tests were performed with standard series of Spanish Contact Dermatitis Group (GEIDAC) and textile series (Bial-Aristegui Labs.): positive PPD (3+), and Disperse Orange3 (DO3) 1% (3+) within 48 and 96 hours. 

Disperse dyes, (mainly azo) are the most common causes of textile-related allergic contact dermatitis. They are used for dyeing synthetic fibers, not for natural ones. Disperse dyes do not chemically bond to the fibers, and their small, liophilic molecules can therefore easily migrate onto the skin of the person who is wearing the garment, especially if the textile fastness is poor; they may be removed by exposure to water. This circumstance could explain why our patient presented dermatitis after bathing and not with regular clothes even orange-colored ones. Cross-reactivity between PPD and DO3, among other textile dyes, has frequently been reported. Asking after patch-test results, our patient referred previous dermatitis related a henna tattoo. This might be the primary sensitization.

Identifying the allergens when contact dermatitis suspected is challenging because despite the European legislation, clothing labels have no declaration on textile dyes.