A Case of Anaphylaxis Caused by Chlorhexidine Digluconate Applied to the Skin Around a Stoma

Abstract

　A 62-year-old woman with urethral cancer was treated by the application of 1% chlorhexidine digluconate (CHG) to the skin around the stoma of a bladder fistula while admitted as a temporary inpatient. She developed an anaphylactic reaction characterized by dyspnea, paresthesia of the hands, pruritic erythema over the entire body, and erythematous swelling on the face. Skin prick tests using 0.02% and 1% CHG and a scratch test using 1% CHG elicited positive reactions. Based on these findings, she was diagnosed as having anaphylaxis caused by CHG. She usually used over-the-counter ointment containing CHG for her hands and feet. CHG is an antiseptic used widely in health care settings, and has been reported to induce anaphylaxis in several countries including Japan. As CHG is included in a number of over-the-counter drugs and cosmetics such as ointments, mouthwashes, toothpaste, eye cream, and hair care products, the risk of sensitization is increasing. It is necessary to raise public awareness regarding the proper use of CHG, including compliance with appropriate usage in terms of application site and drug concentration.

(日本皮膚免疫アレルギー学会雑誌, 3 (3) : 430-435, 2020)