Allergic Contact Dermatitis to Epinephrine

A patient is described who was shown to be allergic by closed patch testing to epinephrine-(L -epinephrine) which was contained in an ophthalmic preparation. The several other ingredients in the fluid vehicle were negative. Repeat patch testing a few months later was again positive for epinephrine, but negative for its stereoisomer D-epinephrine. Still later, further testing to epinephrine, including scratch testing, proved negative. A final episode of clinical contact dermatitis apparently caused by reexposure to the offending ophthalmic preparation was associated with negative patch-test results to epinephrine and the eye drops.