Allergic Contact Dermatitis From Shampoo

A 63-year-old woman presented for medical attention relating to the acute onset of an intensely pruritic, oozing eruption along the hairline, behind the ears and on the upper face. This eruption followed the first use of a new shampoo product.

Key point: This history and clinical appearance is quite typical of allergic contact dermatitis of the scalp, most commonly due to use of jet black hair dye. Without hair dye use, some ingredient in the new shampoo was likely the culprit.

Treatment: A three week tapering course of prednisone, beginning at 60 mg/d was given. The eruption cleared completely.

Note: Cutaneous patch testing would be advisable to pin point the offending allergen and facilitate avoidance in the future. However, the patient refused patch testing.