CASE REPORT article
Front. Pediatr.
Sec. Pediatric Immunology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1531992
This article is part of the Research TopicAdvances in the diagnosis, management and outcomes of Immune-Mediated Skin Diseases in childrenView all 6 articles
Systemic Contact Dermatitis Caused by Benzalkonium Chloride in a family (a child and parents)
Provisionally accepted
- 1Department of Dermatology, Yidu Central Hospital of Weifang, Weifang, China
- 2School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong Province, China
- 3Changle County People's Hospital, Changle, China
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Background: Systemic contact dermatitis (SCD) arises from re-exposure to a sensitizing agent through systemic routes, commonly triggered by drugs, metals, and food additives. Benzalkonium chloride, a cationic surfactant in many household products, can also induce allergic reactions.Case Presentation: An 11-year-old girl and her parents, presented with erythematous, pruritic plaques and scaling. The child exhibited lesions on her anterior chest and popliteal fossae, while her parents had similar lesions on their trunks. She reported no prior allergies or exposure to known allergens, and laboratory results, including blood counts and IgE levels, were normal. Dermoscopic examination showed a bright-red background with focal branching vasculature and white scales. Histopathology revealed hyperkeratosis, parakeratosis, and dermal inflammation. Further investigation revealed that her family had recently begun using a laundry detergent containing benzalkonium chloride. Patch testing was performed using dilutions of this detergent on the patient and her father, both of whom exhibited positive reactions, confirming an allergic response. Upon discontinuation of the detergent and initiation of anti-allergic treatment, symptoms improved, with no recurrence at a three-month follow-up.Discussion: While primarily recognized as an irritant, benzalkonium chloride can cause allergic reactions, particularly in pediatric populations. This case aligns with recent reports of SCD following low-dose, prolonged exposure to this compound.This case emphasizes that benzalkonium chloride can induce SCD even with minimal exposure through household products. Increased awareness of allergens in everyday consumer goods is essential, and further research is needed to elucidate the underlying immunological mechanisms.
Keywords: Systemic contact dermatitis (SCD), Benzalkonium chloride, Pediatric Population, Allergic reactions, Dermatological allergens
Received: 21 Nov 2024; Accepted: 23 May 2025.
Copyright: © 2025 Zhang, Wang, Ma, Zhao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bao-Xiang Zhang, Department of Dermatology, Yidu Central Hospital of Weifang, Weifang, China
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