Airborne allergic contact dermatitis (AACD) can be caused by airborne chemicals fixing on exposed parts of the body. Patch testing is the gold standard for diagnosing allergic contact dermatitis and should be employed in patients with suspected contact dermatitis or chronic dermatitis that does not respond to treatment.

A Case report describes a 67-year-old White woman who presented in October 2019 with a 4-month history of severe pruritic facial and hand dermatitis. She was a retired teacher and did not have any personal or family history of atopic dermatitis, asthma, or rhinitis. She had a history of allergy to amoxicillin and food allergy to lobster (but never underwent prick testing). She completed the course of prednisone for the same. A skin biopsy from her hand showed spongiotic dermatitis (consistent with contact dermatitis). Her dermatitis flared up even after completing the second course of oral prednisone. She took prednisone, oral loratadine, and topical hydrocortisone for her face and was recommended patch testing by her previous dermatologist.

Patch testing showed reaction to quaternium 15 and 10% Tylan powder in petrolatum, thus were considered to be possibly relevant. She was rendered a safe shopping list for quaternium 15 allergen avoidance and suggested discontinuing the use of the Tylan powder additive in her dogs food and was also advised to vacuum clean her kitchen for any residual powder in the environment.

Following 3 months of this advice, her hand dermatitis resolved completely and her facial dermatitis greatly improved. 

Source- Kale A, Gaspari AA. A dog lover′s dilemma: Airborne allergic contact dermatitis to tylosin. JAAD case reports. 2021;7:100-102. DOI:https://doi.org/10.1016/j.jdcr.2020.11.011