Allergic Contact Dermatitis to 1,3-Diphenylguanidine Over a 23-Year Period: Recent Cases Involve Sterile Polyisoprene Gloves.

BACKGROUND

1,3-Diphenylguanidine (DPG) is a known contact sensitiser and rubber vulcaniser.

METHODS

A retrospective audit was performed including 2675 patients tested to 1% DPG in petrolatum between 2002 and 2024. The MOAHLFA index of those with allergic contact dermatitis (ACD) was compared to the remainder of the patch test clinic population. Temporal changes in the prevalence of contact allergy and ACD to DPG were assessed.

RESULTS

50 (1.9%) patients had positive reactions to DPG on patch testing, with 31 (62% of positive reactions) diagnosed with ACD. In those with ACD, there was a significantly higher proportion of men (64.5% vs. 30.6%, p < 0.001), more occupational cases (41.9% vs. 17.7%, p < 0.001), more cases with hand dermatitis (64.5% vs. 33.1%, p < 0.001), more cases aged over 40 years (71.0% vs. 53.2%, p = 0.048), and fewer cases with face dermatitis (9.7% vs. 25.5%, p = 0.043). The most common exposure sources were gloves and shoes, with the four most recent cases involving polyisoprene (PI) gloves. However, information regarding DPG in shoes was lacking, and some patients reacted to multiple haptens, making it unclear as to the primary culprit.

CONCLUSION

DPG causes occupational ACD in especially in healthcare workers (HCW), with recent cases involving exposure to PI gloves.