A public danger induces common action: Contact allergy epidemic to dimethylfumarate in Europe

The methyl ester form of fumaric acid named dimethylfumarate (DMF) is an effective mold and bacteria growth inhibitor. The irritating and sensitizing properties of topical monoethylfumarate and DMF have been described in animal models and healthy volunteers. At that time, itchy maculopapular rash and sensitization were described in occupational sites, pharmacy technicians and polymer industry workers. The strong sensitizing capacity of DMF has been demonstrated in humans. DMF was responsible for an epidemic of contact dermatitis (CD) related to furniture, such as sofas and chairs, and to clothes, such as shoes, hats and jeans. Acute irritant CD, allergic CD, contact urticaria or lichenoid eruption were suffered by patients, even requiring urgent hospital admission. Most of them maintained painful skin even months after the episode. The responsible agent DMF was found mainly in the antimold sachets included in the textile gusset of sofas and shoe boxes of products manufactured in China. DMF 0.1%, in petrolatum, is the suitable patch test material for studying potential new cases. Global preventive measures for avoiding DMF exposure are desirable. © 2011 Expert Reviews Ltd.