Evaluation of Antigenic Determinant in Glutaraldehyde Contact Dermatitis By Patch Testing With Chemically Related Substances

Abstract

Glutaraldehyde normally does not cross-react with formaldehyde. Because both glutaraldehyde and formaldehyde are small organic molecules with simple chemical structures, the author had patch tested a patient with strong contact allergy to glutaraldehyde with a variety of related aldehydes, dialdehydes, and a chemical containing both aldehyde and carboxyl groups. The patient developed a positive reaction only to dialdehydes implying that, at least in this patient, induction of allergic contact dermatitis requires the presence of two aldehyde groups. The aldehyde groups cannot be substituted by a carboxyl group, and the length or type of carbon chain is not very important. A number of healthy individuals served as a control group to assure that positive reactions to dialdehydes were truly allergic and not irritant ones. This novel approach of deriving at the molecular level the antigenic determinant of chemicals that cause contact dermatitis by patch testing with chemically similar and related substances will be helpful in understanding the pathogenesis of contact dermatitis and assisting patients who have contact sensitivities to chemically closely related substances, such as topical anesthetics and steroids.