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Indian J Dermatol
Indian J Dermatol
IJD
Indian J Dermatol
Indian Journal of Dermatology
0019-5154
1998-3611
Wolters Kluwer - Medknow India

IJD-69-354
10.4103/ijd.ijd_396_23
Correspondences
Irritant Contact Dermatitis from Accidental Exposure to a Kitchen Degreaser
Dwivedi Tejasvi
Chirumamilla Sri Sai Kaumudi
Singh Jivtesh
Ganguly Satyaki
From the Department of Dermatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India E-mail: satyakiganguly@yahoo.co.in
Jul-Aug 2024
19 8 2024
69 4 354355
4 2023
4 2024
Copyright: © 2024 Indian Journal of Dermatology
2024
https://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
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pmcDear Editor,

A 37-year-old male, an office worker by profession, not trained in the handling of chemical agents, acquired a partially used plastic container of SwipePro Kitchen Degreaser® [Figure 1] and was transporting it when a spill led to his pants being soaked in the degreaser. The next day, he presented to the Dermatology OPD with a history of a painful wound on his left buttock that had developed in this time. On examination, there was a single erosion of size 4 × 5 cm2 with brownish stain in the central part and surrounding erythema and oedema over the left buttock with a raised temperature and smaller discrete shallow erosions surrounding the central lesion [Figure 2]. He was diagnosed as a case of irritant contact dermatitis due to the kitchen degreaser. He was started on 40 mg prednisolone, a course of tablet cefadroxil 500 mg twice daily for 5 days, tablet paracetamol and tab levocetirizine 5 mg as needed, topical Calamine lotion in the morning, and fusidic acid+beclomethasone cream for night-time application. The patient returned after 3 days with a marked reduction in pain and erythema along with a decrease in oedema, and necrotic crust separating at the margins was noted [Figure 3]. Prednisolone was tapered at 10 mg every 3 days and was stopped after 12 days of treatment. After 3 weeks, when the necrotic crust completely separated, peripheral re-epithelisation was observed. No signs of inflammation or tenderness were observed [Figure 4].

Figure 1 The agent responsible for irritant contact dermatitis (green arrow- safety instructions)

Figure 2 At initial presentation (green arrow- brownish stain)

Figure 3 Presentation at day 3 (green arrow- necrotic crust separating at the margins)

Figure 4 Healing wound with re-epithelization after 3 weeks (green arrow- peripheral re-epithelialisation)

Irritant contact dermatitis can result from direct contact with a variety of household and workplace cleaning products such as bleach, ammonia, drain cleaners and declogging agents, fertilizers, and paint thinners, which have been reported in the literature and case reports.[1] Kitchen degreasers are an unusual source of severe irritant contact dermatitis, and cases have been reported from industrial manufacturing and commercial operation settings as occupational exposure.[2] The specific agents in this kitchen degreaser were not listed on the product label and could not be obtained by contacting the company that supplies these to their staff. Most kitchen degreasers are made from two main components: alkaline builders and surfactants. While the surfactant is relatively harmless, the alkali is responsible for the irritant contact dermatitis. Alkalis dissolve proteins and collagen, resulting in the formation of soluble protein complexes. These then allow the agent to penetrate deeper into the tissue, causing more damage and making irrigation difficult. Alkaline agents commonly used are sodium hydroxide, soda ash, sodium silicate, and sodium tripolyphosphate. Sodium metasilicate is a very strong base that is commonly used. Commonly used surfactants are fatty alcohol polyoxyethylene ether (AEO) series, alkylphenol polyoxyethylene ether (TX, NP) series, etc.[3] We stress upon the significance of exercising caution among all those not trained in the handling and use of these products. We also suggest that components and their concentrations be listed on the product label to aid in medical management in case of such mishaps. While operating instructions and safety recommendations were listed on the product label, instructions to go to a medical centre in case of exposure and that only trained personnel should use these products should also be specified.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.
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1 Jacobsen G Rasmussen K Bregnhøj A Isaksson M Diepgen TL Carstensen O Causes of irritant contact dermatitis after occupational skin exposure: A systematic review Int Arch Occup Environ Health 2022 95 35 65 34665298
2 Lavoué J Bégin D Géerin M Technical, occupational health and environmental aspects of metal degreasing with aqueous cleaners Ann Occup Hyg 2003 47 441 59 12890654
3 Ceresana.com Surfactants Market Report –World 3rd edition 2017 Available from: https://ceresana.com/en/produkt/surfactants-market-report-world [Last accessed on 2023 Apr 04]
