Clinicopathologic Features of Systemic Contact Dermatitis from Ethylenediamine in Cetirizine and Levocetirizine

Case Report A 49-year-old woman had a long-standing eczematous foot lesion which she had been self-treating for at least 6 months with topical remedies including a halcinonide-neomycin-amphotericin B ointment containing ethylenediamine as a stabilizer (Anfocort). As the clinical picture did not improve, her general practitioner intermittently administrated betamethasone and cetirizine for about 3 months, and finally systemic therapy with deflazacort and levocetirizine. In spite of this treatment, the skin eruption consistently worsened and spread; so, when the patient was first seen after about a week of this latter regimen, she showed a generalized eruption ( fig. 1 ). A skin biopsy was performed after a 1-week washout period from the systemic steroid. Histologic examination of 2 skin biop