Baby-wipe dermatitis: Preservative-induced hand eczema in parents and persons using moist towelettes

Background: Hand eczema can have complex causative or aggravating influences, and the pattern, history, and patch test data are helpful in identifying sources and antigen substitution. Objective: We studied our patients with hand eczema associated with exposure to baby wipes for pattern and sensitivities. Methods: Patient records over a 10-year period containing key words were reviewed for relevance of exposure, patch test data, and outcome. Results: A total of 6 women and 3 men with hand eczema were found to be allergic to (preservatives found in) different brands of moist towelettes used in diaper hygiene. Many were allergic to fragrance materials as well. The eruptions were mostly worse on the thumb and 2 adjacent fingers, with which the item was held. Five of the 9 were parents of infants, although no infant had a problem. Only 1 patient suspected the source. All improved with avoidance, although most had multiple other contact allergies, including corticosteroids. Conclusions: Hand eczema in a grip-like pattern is good reason to inquire about baby wipes as a possible source, as most patients do not recognize that source even after undergoing patch tests.