however , the style of the application may induce both allergic and photoallergic contact dermatitis from the nsaids and their ingredients .
we describe a case of allergic contact dermatitis with diffuse erythematous reaction caused by allergic sensitivity to a component , diisopropanolamine , of a compress used by the patient .
an 87-year - old japanese man with dementia presented with a pruritic eruption following the use of compresses for lumbago .
the patient had used the same compresses for three weeks . during the last ten days of use
, pruritic eruptions appeared on the bilateral lower back and upper buttock where the compresses were being applied .
then , diffuse erythema developed on the trunk and extremities . physical examination revealed rectangular - shaped , pruritic exudative erythematous macular lesions on the bilateral lower back and upper buttock and diffuse erythema on the chest , abdomen , back and extremities ( fig .
a patch test ( international contact dermatitis research group criteria ; finn chambers on scanpor tape , epitest ltd . ,
tuusula , finland ) was performed with the compress ingredients and the japanese baseline series .
the positive reactions at both 2 and 4 days after application were to diisopropanolamine 1% pet . , fragrance mix 8% pet .
( brial allergen gmbh , greven , germany ) , and mercuric chloride 0.05% aq .
it is used in emulsifying agents for cosmetic lotions , neutralizers in cosmetics , and bath preparations . until now ,
eight cases of allergic contact dermatitis from diisopropanolamine , including the present case , have been described ( table 1 ) .
we previously reported a case of diffuse erythematic reaction after using compresses . in the previous case ,
three concomitant sensitizations to diisopropanolamine , felbinac , and crotamiton supposedly caused a diffuse erythematic reaction .
in the present case , a single sensitization to diisopropanolamine was associated with a diffuse erythema .
thus , similar phenomena of allergic contact dermatitis with diffuse erythematous reaction may be caused by allergic sensitivity to a different component or different combinations of ingredients in the topical medicament .
patch testing with full ingredients from the manufacturer is essential for detecting the sensitized allergens in each case .
 compresses containing a nonsteroidal antiinflammatory drug ( nsaid ) are commonly used in japan . however 
 , this treatment may induce both allergic and photoallergic contact dermatitis from the nsaids and their ingredients . here , we describe a case of allergic contact dermatitis with diffuse erythematous reaction due to diisopropanolamine in the applied compress . 
 the absorption of diisopropanolamine might have been enhanced by the occlusive condition . 
Introduction
Case Report
Discussion