Document RaRp5MQb894exEr1MNmr9vx4v

R&S 136069 f ! IVN. \u l.t J'l l~<- 1159 ...................................... M "c?/? ^r ' )P^ (ionlact Dermatitis Caused by Saran Wrap Nnvimmrf ,i. Osbourn. )1D. IT nthinteton, DC RECENTLY, the use <if thin plastic films as cov ering or occlusive dressings in therapy with ointments and creams, especially hydrocortisone derivatives, has been advocated for treatment of several dermatoses,1'' This form of therapy is often very beneficial and is becoming increasingly popu lar. Only a few complications have been reported from the use of such films. Among them were dis comfort from perspiration under the film, a miliarialike eruption, and folliculitis.1-3 Where hydrocorti sone derivatives were used, atrophy has also been . ____________ ____ ; Vokulafion end erythema dfttr Saron Wrop patch f*if, Subiqunt detqvomotian at this site. ; reported.3 It is our purpose to report a rare complication, ie, contact dermatitis, from the use of a film (Saran Wrap) itself. Report of a Case A 30->v.ir-old white male consulted us on May 2, 1963, because of psoriasis involving his scalp, legs, and arms. According to his medical history, he had had intermittent attacks of psoriasis for many years. He had in the past been treated with aminnpterin and cortisone preparations and had used Saran Wrap with local hydrocortisone and related steroid creams. Because an area of psoriasis on his right leg was quite localized, he was given a steroid cream tontaining triamcinolone acetonide, neomycin sulfate, grami cidin. and nystatin arid was told to cover the area with Saran Wrap for two- to three-hour periods every evening. He applied the same cream without covering to the other Mattered ar<-a,s on his arms and legs and he used a scalp lotion containing resorcinol monoacctate. Over the nest few weeks, the patient showed improve ment of all his skin lesions. However, on June 6 he returned with an inflamed, swollen, vesicular and exudative derma skin reactions reported to them ox er the years the product has been on the market.3 There is a report of skin reactions to epoxy resins used as plasticizers and stabilizers in poly vinyl chloride films,'1 but these substances, accord ing to information received from the manufacturer, are not used in the Saran Wrap film.3 Furthermore, xve lux'c not been able to find in the literature any reference to reactions to the pure polyvinylchloride or to the copolymer of it with vinylidine. In view of the large amount of Saran Wrap in past and present daily use, it is obvious that skin sensitivity to it must indeed he rare. However, be cause the dermatitis in this patient was limited to the area of its application and because of the posi tive patch test reaction to the product itself, the possibility of skin reactions to Saran Wrap must be kept in mind xvhen it is used as an occlusive dress ing for therapy. titis on his right leg. rather sharply limited to the area covered by the Saran Wrap. The other skin areas on which the same triameinolone preparation was used uncovered were not inflamed. He was advised to avoid the Saran Wrap, to use a colloidal aluminum acetate (Buroxv's) so lution soak and apply a hydrocortisone-neomycin spray. The inflammation subsided uneventfully over the next few djys. A patch with a 1-cm square of Saran Wrap was applied to the flexor surface of his left forearm where the skin appeared essentially normal. In 48 hours, the test site bowed redness and vcsieiilation (Figure). The patient ii.ul < 11 ti 11 11 lo 11m- (In- sunn- triamcinolone cream svitlioot itiltn nlty on filin') sjin ,ni-as. One xveeh later the patient .ippiied (his s.mte in-.iiii In liie right leg when- the .Sninn Wrap had been used lint no reaction was produced. Comment Saran Wrap is a copolymer of vinylidine chloride and vinylchloride. Generally, it is considered to be relatively inert. The manufacturers advised that 1833 Eye. St, N\V, Washington 6, DC. Cencric and Trade Names of Drugs Triamcinolone acetonide--Arhtocort Acetonide, Aristoderni, Kcnalog. Neomycin sulfate--Mycifradio Snlfalc, Alycigucnt, Scomycin Sulfate. Nystatin--\hjco\tdtin. References 1. .Snl/lu-igt-r, M.U., and Witten, V.H.: Thin Pliable Plastic Films in 'I'lipical I )i-riii.ilolngic Therapy, Ari li Drrm (Cl,I,,ir.nl 8l:lfl.:7 fl ><<-) IHIII 2. .Schultz, J.H.: To[iic:il Theiapy of Psoriasis with Fluocioolone Acetonide, Arc/1 Derm (Chicago) 8-1:102!) (Dee) 1961. 3. Witten, U.H.: Stein. S.J.; and Michaclides, P.: Use of Thin Pliable Plastic Film in Selected Dermatoses, Arch Derm (Chicago) S7:438 (April) 1963. 1. Editor's note: Tear Book of Dermatology, 1062-6-3, they did not have a single positive reaction in all the skin testing which they did on Saran Wrap as it is commercially available, nor have they had any Ftom the [Vp.irtment of Mfdicinc (Dcrnrt.itoloKy) of Gtforifctown Unn trrxity Mt-<h<,nl Center. Chicago: Year Book Medical Publishers, 1963, p -13. 5. Dow Chemical Co.: Communication to the author. 6. Fregert, S., and Rnrsman, II.: Hypersensitivity to Epoxy Resins Used as Plasticizers and Stabilizers in Poly vinyl Chloride Resins, Acfct Dcrmatovcncr (Stockholm) 43:10-13, 196-3. I II