Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)

BackgroundSystemic contact dermatitis (SCD) occurs due to re-exposure to sensitizing agents via systemic routes, often triggered by drugs, metals, and food additives. Benzalkonium chloride, a cationic surfactant in different household products, can also induce allergic reactions.Case presentationAn...

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Main Authors: Lu Zhang, Yu-Jie Wang, Yu-Han Ma, Guo-Dong Zhao, Bao-Xiang Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1531992/full
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author Lu Zhang
Yu-Jie Wang
Yu-Han Ma
Guo-Dong Zhao
Bao-Xiang Zhang
author_facet Lu Zhang
Yu-Jie Wang
Yu-Han Ma
Guo-Dong Zhao
Bao-Xiang Zhang
author_sort Lu Zhang
collection DOAJ
description BackgroundSystemic contact dermatitis (SCD) occurs due to re-exposure to sensitizing agents via systemic routes, often triggered by drugs, metals, and food additives. Benzalkonium chloride, a cationic surfactant in different household products, can also induce allergic reactions.Case presentationAn 11-year-old girl and her parents presented to our outpatient clinic with erythematous, pruritic plaques and scaling. The girl displayed lesions on her anterior chest and popliteal fossae, moreover her parents had similar lesions on their trunks. Notably, she had no previous allergic responses, and furthermore the laboratory results, including blood counts and IgE levels, were normal. Dermoscopic examination revealed a bright-red background with focal branching vasculature and white scales. Histopathology indicated hyperkeratosis, parakeratosis, and dermal inflammation. However, further investigation uncovered that the family had recently started using a laundry detergent containing benzalkonium chloride. What's more, patch testing with dilutions of the detergent was conducted on the girl and her father, both of whom showed positive reactions, which confirming an allergic response. So they were diagnosed as systemic contact dermatitis (SCD). The rash gradually subsided after the detergent was stopped and the anti-allergy treatment was carried out, and there was no recurrence during the 3-month follow-up.DiscussionAlthough benzalkonium chloride is mainly regarded as an irritant, it can induce an allergic reaction, particularly in pediatric populations. The case indicates that benzalkonium chloride can trigger SCD even with minimal exposure through household products, and further research is needed to elucidate the underlying immunological mechanisms.ConclusionThis 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.
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spelling doaj-art-c315c94d34ec421a8dea355f4f91a1082025-08-20T02:23:00ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-06-011310.3389/fped.2025.15319921531992Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)Lu Zhang0Yu-Jie Wang1Yu-Han Ma2Guo-Dong Zhao3Bao-Xiang Zhang4Department of Dermatology, Yidu Central Hospital of Weifang City, Qingzhou, ChinaDepartment of Dermatology, Yidu Central Hospital of Weifang City, Qingzhou, ChinaSchool of Clinical Medicine, Shandong Second Medical University, Weifang, ChinaDepartment of Dermatology, Changle County People’s Hospital, Changle, ChinaDepartment of Dermatology, Yidu Central Hospital of Weifang City, Qingzhou, ChinaBackgroundSystemic contact dermatitis (SCD) occurs due to re-exposure to sensitizing agents via systemic routes, often triggered by drugs, metals, and food additives. Benzalkonium chloride, a cationic surfactant in different household products, can also induce allergic reactions.Case presentationAn 11-year-old girl and her parents presented to our outpatient clinic with erythematous, pruritic plaques and scaling. The girl displayed lesions on her anterior chest and popliteal fossae, moreover her parents had similar lesions on their trunks. Notably, she had no previous allergic responses, and furthermore the laboratory results, including blood counts and IgE levels, were normal. Dermoscopic examination revealed a bright-red background with focal branching vasculature and white scales. Histopathology indicated hyperkeratosis, parakeratosis, and dermal inflammation. However, further investigation uncovered that the family had recently started using a laundry detergent containing benzalkonium chloride. What's more, patch testing with dilutions of the detergent was conducted on the girl and her father, both of whom showed positive reactions, which confirming an allergic response. So they were diagnosed as systemic contact dermatitis (SCD). The rash gradually subsided after the detergent was stopped and the anti-allergy treatment was carried out, and there was no recurrence during the 3-month follow-up.DiscussionAlthough benzalkonium chloride is mainly regarded as an irritant, it can induce an allergic reaction, particularly in pediatric populations. The case indicates that benzalkonium chloride can trigger SCD even with minimal exposure through household products, and further research is needed to elucidate the underlying immunological mechanisms.ConclusionThis 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.https://www.frontiersin.org/articles/10.3389/fped.2025.1531992/fullsystemic contact dermatitis (SCD)benzalkonium chloridepediatric populationallergic reactionsdermatological allergens
spellingShingle Lu Zhang
Yu-Jie Wang
Yu-Han Ma
Guo-Dong Zhao
Bao-Xiang Zhang
Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
Frontiers in Pediatrics
systemic contact dermatitis (SCD)
benzalkonium chloride
pediatric population
allergic reactions
dermatological allergens
title Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
title_full Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
title_fullStr Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
title_full_unstemmed Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
title_short Case Report: Systemic contact dermatitis caused by benzalkonium chloride in a family (a child and parents)
title_sort case report systemic contact dermatitis caused by benzalkonium chloride in a family a child and parents
topic systemic contact dermatitis (SCD)
benzalkonium chloride
pediatric population
allergic reactions
dermatological allergens
url https://www.frontiersin.org/articles/10.3389/fped.2025.1531992/full
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