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had had vitiligo for several years and had received topical treatment with corticosteroids&#44; tacrolimus 0&#46;1&#37;&#44; and&#47;or narrowband UV-B therapy&#46; They all experienced a local eczematous reaction at the site of application between 3 weeks and 2 months after first use&#46; The use test with the commercial product yielded a positive result in all 3 cases&#46; The patients subsequently underwent patch testing with the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group &#40;GEIDAC&#41; and with the 2 components of the product&#58; the active ingredient&#44; Pigmerise&#44; diluted to 1&#37; and 0&#46;4&#37; in white petrolatum&#59; and its vehicle&#44; the hydrophilic gel cream Fitalite&#46; Both components were supplied by the company sales representative&#46; In all 3 cases&#44; the results were positive at 48<span class="elsevierStyleHsp" style=""></span>hours and at 96<span class="elsevierStyleHsp" style=""></span>hours with the black pepper extract at both concentrations &#40;Pigmerise&#44; 0&#46;4&#37; and 1&#37;&#41; and negative with Fitalite &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Test results were positive for 2 of the patients with the Spanish standard series&#44; albeit without present relevance &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Furthermore&#44; patient 2 experienced a reactivation phenomenon during the patch tests&#44; with the appearance of eczematous plaques on the antecubital skinfolds and axilla&#44; where the product had been applied&#46; Patch testing with 25 healthy controls yielded negative results&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The use of plant-derived products for both cosmetic and medicinal purposes has increased considerably in recent years&#46; Evidence from clinical trials on the safety and efficacy profile of these products before marketing is generally lacking&#46; The use of plant-derived products is not free of risks&#44; and topical application can cause various types of local reaction&#44; the main ones being irritant contact dermatitis&#44; allergic contact dermatitis&#44; contact urticaria&#44; photoaggravated eczema&#44; and phototoxic reactions&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The recently marketed Pigmerise 20&#37; in Fitalite for treatment of vitiligo contains an active ingredient composed of a natural phytocomplex of liquid oleoresin derived from black pepper extract &#40;<span class="elsevierStyleItalic">Piper nigrum L</span> or piperine&#41;&#46; This is formulated at 20&#37; in a hydrophilic gel cream with high concentrations of triglycerides of linoleic and oleic acid known as Fitalite&#46; The compound is thought to act by activating proliferation of melanocytes&#44; as previously shown in vitro&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> However&#44; we were unable to find articles or other publications with safety and efficacy data for this product&#58; since it is marketed as a class I product&#44; pharmacovigilance studies are not necessary&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The literature to date does not contain published cases of allergic contact dermatitis caused by black pepper extract &#40;piperine&#41;&#59; therefore&#44; the 3 cases we report are the first cases of allergic contact dermatitis to Pigmerise&#46; The cases highlight the need to establish strict epidemiological vigilance&#44; in which the dermatologist plays a key role by identifying such reactions&#44; especially those associated with topical products&#44; and reports confirmed cases to the Spanish Agency of Medicines and Medical Devices&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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Case and Research Letters
Contact Dermatitis Due to Black Pepper Extract Used to Treat Vitiligo
Eccema de contacto por extracto de pimienta negra como tratamiento de vitíligo
E. García-Zamora
Autor para correspondencia
garciazamoraelena@gmail.com

Corresponding author.
, E. Gómez de la Fuente, R. Miñano-Medrano, M. Gutiérrez-Pascual, J.L. López-Estebaranz
Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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had had vitiligo for several years and had received topical treatment with corticosteroids&#44; tacrolimus 0&#46;1&#37;&#44; and&#47;or narrowband UV-B therapy&#46; They all experienced a local eczematous reaction at the site of application between 3 weeks and 2 months after first use&#46; The use test with the commercial product yielded a positive result in all 3 cases&#46; The patients subsequently underwent patch testing with the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group &#40;GEIDAC&#41; and with the 2 components of the product&#58; the active ingredient&#44; Pigmerise&#44; diluted to 1&#37; and 0&#46;4&#37; in white petrolatum&#59; and its vehicle&#44; the hydrophilic gel cream Fitalite&#46; Both components were supplied by the company sales representative&#46; In all 3 cases&#44; the results were positive at 48<span class="elsevierStyleHsp" style=""></span>hours and at 96<span class="elsevierStyleHsp" style=""></span>hours with the black pepper extract at both concentrations &#40;Pigmerise&#44; 0&#46;4&#37; and 1&#37;&#41; and negative with Fitalite &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Test results were positive for 2 of the patients with the Spanish standard series&#44; albeit without present relevance &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Furthermore&#44; patient 2 experienced a reactivation phenomenon during the patch tests&#44; with the appearance of eczematous plaques on the antecubital skinfolds and axilla&#44; where the product had been applied&#46; Patch testing with 25 healthy controls yielded negative results&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The use of plant-derived products for both cosmetic and medicinal purposes has increased considerably in recent years&#46; Evidence from clinical trials on the safety and efficacy profile of these products before marketing is generally lacking&#46; The use of plant-derived products is not free of risks&#44; and topical application can cause various types of local reaction&#44; the main ones being irritant contact dermatitis&#44; allergic contact dermatitis&#44; contact urticaria&#44; photoaggravated eczema&#44; and phototoxic reactions&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The recently marketed Pigmerise 20&#37; in Fitalite for treatment of vitiligo contains an active ingredient composed of a natural phytocomplex of liquid oleoresin derived from black pepper extract &#40;<span class="elsevierStyleItalic">Piper nigrum L</span> or piperine&#41;&#46; This is formulated at 20&#37; in a hydrophilic gel cream with high concentrations of triglycerides of linoleic and oleic acid known as Fitalite&#46; The compound is thought to act by activating proliferation of melanocytes&#44; as previously shown in vitro&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> However&#44; we were unable to find articles or other publications with safety and efficacy data for this product&#58; since it is marketed as a class I product&#44; pharmacovigilance studies are not necessary&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The literature to date does not contain published cases of allergic contact dermatitis caused by black pepper extract &#40;piperine&#41;&#59; therefore&#44; the 3 cases we report are the first cases of allergic contact dermatitis to Pigmerise&#46; The cases highlight the need to establish strict epidemiological vigilance&#44; in which the dermatologist plays a key role by identifying such reactions&#44; especially those associated with topical products&#44; and reports confirmed cases to the Spanish Agency of Medicines and Medical Devices&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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