Slime is not sublime: It may cause hand dermatitis

Homemade, borax-containing “slime” can contribute to hand dermatitis.

A young, otherwise healthy 9-year-old girl was evaluated for pruritic hand dermatitis which lasted 5 months after exposure to homemade slime. Physical exam revealed erythematous, scaly plaques on the palmar surfaces of her hands; her fingernails had onychomadesis and longitudinal ridging. Despite frequent emolliation, her dermatitis persisted. She was then treated empirically for scabies and for culture-positive Staphylococcus aureus infection, which required a full round of cephalexin and mupirocin ointment. This also did not alleviate the dermatitis. A combination of homemade borax-containing slime avoidance, brief course of high-dose corticosteroids, and frequent bland emollients was prescribed because the dermatitis was assumed to be caused by an irritant.

Many of the ingredients in homemade slime recipes are common household ingredients that are known to cause irritant or allergic contact dermatitis. Irritant contact dermatitis is a response from the innate immune system and is more frequent than the more severe allergic contact dermatitis, a type IV–mediated hypersensitivity reaction.

After review of this case and evaluation of other children with hand dermatitis, Julia K. Gittler, MD, of Columbia University, New York, and her colleagues have made a case that “slime” and new-onset hand dermatitis may be linked.

[email protected]

SOURCE: Gittler JK et al. J Pediatr. 2018 May 3. doi: 10.1016/j.jpeds.2018.03.064 .

Homemade, borax-containing “slime” can contribute to hand dermatitis.

A young, otherwise healthy 9-year-old girl was evaluated for pruritic hand dermatitis which lasted 5 months after exposure to homemade slime. Physical exam revealed erythematous, scaly plaques on the palmar surfaces of her hands; her fingernails had onychomadesis and longitudinal ridging. Despite frequent emolliation, her dermatitis persisted. She was then treated empirically for scabies and for culture-positive Staphylococcus aureus infection, which required a full round of cephalexin and mupirocin ointment. This also did not alleviate the dermatitis. A combination of homemade borax-containing slime avoidance, brief course of high-dose corticosteroids, and frequent bland emollients was prescribed because the dermatitis was assumed to be caused by an irritant.

Many of the ingredients in homemade slime recipes are common household ingredients that are known to cause irritant or allergic contact dermatitis. Irritant contact dermatitis is a response from the innate immune system and is more frequent than the more severe allergic contact dermatitis, a type IV–mediated hypersensitivity reaction.

After review of this case and evaluation of other children with hand dermatitis, Julia K. Gittler, MD, of Columbia University, New York, and her colleagues have made a case that “slime” and new-onset hand dermatitis may be linked.

[email protected]

SOURCE: Gittler JK et al. J Pediatr. 2018 May 3. doi: 10.1016/j.jpeds.2018.03.064 .

Homemade, borax-containing “slime” can contribute to hand dermatitis.

A young, otherwise healthy 9-year-old girl was evaluated for pruritic hand dermatitis which lasted 5 months after exposure to homemade slime. Physical exam revealed erythematous, scaly plaques on the palmar surfaces of her hands; her fingernails had onychomadesis and longitudinal ridging. Despite frequent emolliation, her dermatitis persisted. She was then treated empirically for scabies and for culture-positive Staphylococcus aureus infection, which required a full round of cephalexin and mupirocin ointment. This also did not alleviate the dermatitis. A combination of homemade borax-containing slime avoidance, brief course of high-dose corticosteroids, and frequent bland emollients was prescribed because the dermatitis was assumed to be caused by an irritant.

Many of the ingredients in homemade slime recipes are common household ingredients that are known to cause irritant or allergic contact dermatitis. Irritant contact dermatitis is a response from the innate immune system and is more frequent than the more severe allergic contact dermatitis, a type IV–mediated hypersensitivity reaction.

After review of this case and evaluation of other children with hand dermatitis, Julia K. Gittler, MD, of Columbia University, New York, and her colleagues have made a case that “slime” and new-onset hand dermatitis may be linked.

[email protected]

SOURCE: Gittler JK et al. J Pediatr. 2018 May 3. doi: 10.1016/j.jpeds.2018.03.064 .