A Hard-to-Heal Cutaneous Ulcer: An Exuberant Case of Allergic Contact Dermatitis to L-Mesitran® Tulle

Joana Calvão; Ricardo Batista; Margarida Gonçalo

doi:10.29021/spdv.78.1.1149

Joana Calvão Serviço de Dermatologia, CHUC https://orcid.org/0000-0002-1161-269X
Ricardo Batista Serviço de Saúde Ocupacional, CHUC
Margarida Gonçalo Serviço de Dermatologia, CHUC; Clínica de Dermatologia, Faculdade de Medicina, Universidade de Coimbra https://orcid.org/0000-0001-6842-1360

DOI: https://doi.org/10.29021/spdv.78.1.1149

Keywords: Bandages, Dermatitis, Allergic Contact, Lanolin

Abstract

L-Mesitran Tulle® is a popular non-adherent polyethylene dressing impregnated with the patented L-Mesitran Soft gel that contains Medilan™, which is said to be a “hypoallergenic lanolin”. Lanolin is a well know sensitizer and the prevalence of contact allergy to lanolin alcohols varies from 0.6% - 6.9%. We report the case of a patient who develop eczema around the leg ulcer while using L-Mesitran Tulle® as a wound dressing, highlighting that even this “high purity medical grade of lanolin” (Medilan™) contained in L-Mesitran Tulle® can cause an allergic contact dermatitis.

Downloads

Download data is not yet available.

References

McLoone P, Oluwadun A, Warnock M, Fyfe L. Honey: A Therapeutic Agent for Disorders of the Skin. Cent Asian J Glob Heal. 2016;5(1). doi:10.5195/cajgh.2016.241

Wakelin SH, Smith H, White IR, Rycroft RJG, Mcfadden JP. A retrospective analysis of contact allergy to lanolin. Br J Dermatol. 2001;145(1):28-31. doi:10.1046/j.1365-2133.2001.04277.x

Nguyen JC, Chesnut G, James WD, Saruk M. Allergic contact dermatitis caused by lanolin (wool) alcohol contained in an emollient in three postsurgical patients. J Am Acad Dermatol. 2010;62(6):1064-1065. doi:10.1016/j.jaad.2009.10.020

Fransen M, Overgaard LEK, Johansen JD, Thyssen JP. Contact allergy to lanolin: temporal changes in prevalence and association with atopic dermatitis. Contact Dermatitis. 2018;78(1):70-75. doi:10.1111/cod.12872

Epstein E, Mateo S. The detection of lanolin allergy. JAMA Dermatology. 1972;106:678-681.

Knijp J, Bruynzeel DP, Rustemeyer T. Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101. Contact Dermatitis. 2019;80(5):298-303. doi:10.1111/cod.13210

Uter W, Schnuch A, Geier J. Contact sensitization to lanolin alcohols and Amerchol® L101 – analysis of IVDK data. Contact Dermatitis. 2018;78:355-371. doi:10.1111/cod.12907

Gilissen L, Goossens A. Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period. Contact Dermatitis. 2016;75(5):290-302. doi:10.1111/cod.12621

Stone L. Medilan: A hypoallergenic lanolin for emollient therapy. Br J Nurs. 2000;9(1):54-57. doi:10.12968/bjon.2000.9.1.6415