Allergic contact dermatitis caused by dimethylthiocarbamylbenzothiazole sulfide ( DMTBS DMTBS ) in canvas shoes: in search of the culprit allergen

摘要

Summary Background During rubber vulcanization, new compounds can be formed. Objectives To report a case of allergic shoe dermatitis in which the search for the allergen ultimately led to the identification of dimethylthiocarbamylbenzothiazole sulfide (DMTBS) . Methods A female presented with eczema on her feet after wearing S perry T op S ider? canvas sneakers. Patch testing was performed with the E uropean baseline series, additional series, shoe materials, and extracts of shoe materials. Thin‐layer chromatography ( TLC ) was performed for additional patch testing, and high‐performance liquid chromatography and gas chromatography–mass spectometry were used for chemical analysis. Results Positive reactions were found to thiuram mix (+), tetramethylthiuram monosulfide ( TMTM ) (+), shoe material (+), and shoe extracts in eth. (++) and acetone (+). The extracts did not contain TMTM or other components of thiuram mix. TLC strips yielded a positive reaction (+) to one spot, whereas chemical analysis gave a negative result. Thereafter, a similar sneaker from another patient with shoe dermatitis was analysed, and DMBTS was identified. New extracts of the shoe of our first patient were then also shown to contain DMTBS . DMTBS as culprit allergen was confirmed by positive patch testing with a dilution series with DMTBS . Conclusion DMBTS was identified as the culprit allergen in shoe dermatitis, giving rise to compound allergy. The positive reaction to TMTM was considered to represent cross‐reactivity.