Exfoliative erythroderma, characterized clinically by universal erythema and desquamation of skin, is a serious dermatologic condition. Drug allergy is the cause of about 10% of the cases of exfoliative erythroderma,1,2 and such cases are clinically and histologically similar to erythroderma due to other causes.
Ethylenediamine is a common industrial agent used as a dibasic stabilizer in many dyes, fungicides, synthetic waxes, insecticides, resins, and asphalt wetting agents. Medical sources of ethylenediamine include aminophylline (a combination of 80% theophylline and 15% ethylenediamine hydrochloride), a cream composed of triamcinolone acetonide, neomycin sulfate, gramicidin, and nystatin (Mycolog), and various ophthalmic solutions in which edetic acid is utilized as a preservative. Ethylenediamine has been demonstrated to be a fairly potent sensitizer and inducer of contact dermatitis.3-7 Provost and Jillson5 found that systemically administered aminophylline could lead to exacerbations of patchy eczematous eruption in patients with ethylenediamine sensitivity induced by Mycolog cream.