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Dimethyl fumarate contact dermatitis of the foot: an increasingly widespread disease

Authors

  • Angelo Massimiliano D’Erme MD,

    1. Allergological and Occupational Dermatology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
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  • Andrea Bassi MD,

    1. Allergological and Occupational Dermatology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
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  • Torello Lotti MD,

    1. Allergological and Occupational Dermatology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
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  • Massimo Gola MD

    1. Allergological and Occupational Dermatology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
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  • The authors declare no affiliation or significant financial involvement in any organizations or entity with a direct financial interest in the subject matter or materials discussed in the manuscript on this page.

Dr Massimo Gola, md
Allergological and Occupational Dermatology Unit
Department of Critical Care Medicine and Surgery
University of Florence
Piazza dell’Indipendenza 11
50129 Florence
Italy
E-mail: massimo.gola@asf.toscana.it

Abstract

Background  Dimethyl fumarate (DMF) has been recognized as an extremely potent irritant and sensitizer found in sachets inside furniture. The first skin manifestations were correlated to contact with sofas, chairs, and other furniture. In these last years, some papers have reported a development of allergic contact dermatitis on the foot caused by DMF present in high concentration in shoes made in China.

Methods  We report the case of a 37-year-old woman who presented with severe eczema on the foot shortly after having bought a new pair of shoes. The diagnosis was performed by patch tests with DMF in several dilutions, with pieces of internal and external parts of the shoes, and by chemical analysis of the shoes.

Results  In the last three years, goods containing DMF increased diffusely despite the augmentation on global preventive measures by Europe.

Conclusions  Therefore, new cases of contact dermatitis could be dependent on DMF, and it is of note that this allergen is not included in most series for patch testing.

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