Hand dermatitis in healthcare workers: 15‐years experience with hand sanitizer solutions

Our case illustrates an immediate type reaction to chlorhexidine manifesting as contact urticaria. Contact urticaria is characterized by the development of wheals and flare skin or a mucosal reaction after skin contact with an external agent. Symptoms develop typically within 20 to 30 minutes of exposure and disappear within 24 hours. Cases of immediate type reaction to chlorhexidine have rarely been reported. Urticarial reactions have been documented previously following skin exposure to chlorhexidine, and also after mucosal exposure via the vaginal, oral, and urethral route. Contact urticaria can evolve to generalized urticaria and anaphylaxis. Given the current frequent use of hydroalcoholic gel, it is important to be aware of chlorhexidine's potential to cause contact urticarial and severe immediate hypersensitivity reactions.