J. Soc. Cosmetic Chemists, 18,361-365 (May 27, 1967) Use of Two Prophetic Patch Tests for the Practical Determination of Photosensitization Potential of Widely Used Deodorant Soaps* SAMUEL M. PECK, M.D., F.R.S.H.,•' and LEONARD J. VINSON, Ph.D. Synopsis--Schwartz-Peck and Draize-Shelansky hmnan patch tests, modified to include UV irradiation, with soaps containing 3,4•,5-tribroinosalicylanilide and 4',5-dibromosalicylanilide caused no photosensitization in the 150 subjects tested. These results confirm that these antiinicrobial agents have a very low photosensitization potential. INTRODUCTION The attention of the physician has become increasingly focused on cases of photosensitivity from therapeutic agents used internally and from antibacterial agents employed in topical products. Regarding the latter, a recent editorial in the Journal of the American Medical Associa- tion stressed the importance of the need for physicians to be alerted on these occurrences with reference to deodorant soaps (1). The fact that antimicrobial agents used in soap have been implicated in isolated cases of photodermatitis is not a cause for alarm. It is gen- erally accepted that in the population at large susceptibility by hyper- sensitive people to many useful agents (perfumes, sulfonamides, tran- quilizers, and even certain natural products) does occur and manifests itself as dermatitis of the skin in the exposed areas. Of course, it is vital that the physician be cognizant of such incidents in order to be in a posi- tion to diagnose, treat effectively, and advise the patient accordingly. Reports by Jillson and Baughman (2), Baughman (3), Epstein and Enta (4), Molloy and Mayer (5), and Harber et al. (6), of case histories of by- * Supported by a grant from Lever Brothers Co. t Dept. of Dermatology, Mount Sinai School of Medicine, New York, N.Y. 10029. :• Lever Brothers Co., Research Center, Edgewater, N.J. 07020. 361
362 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS persensitive patients shown to be photoallergic to deodorant agents em- ployed in topical products are valuable in alerting the physician to such incidents. Unfortunately, however, some of these reports are being miscon- strued and interpreted to indicate that widely accepted antibacterial agents, such as polybrominated salicylanilides, may be possible hazards to the normal healthy subject. The facts do not support such implica- tions. These agents have been used for the past nine years in toilet soaps, not introduced recently as mistakenly stated by Harber et al. (6). During this time, literally hundreds of millions of bars have been mar- keted with excellent consumer acceptance. The strong upward trend in consumer sales in recent years, in part, reflects the significant health contributions of soaps with bacteriostats, namely: (i) regular use of soaps containing effective antibacterial agents results in significant reductions in cutaneous bacterial counts (7) (ii) maintenance of low cutaneous counts has the effect of reducing body odor development due to bacterial attack on skin waste products and secre- tions for sustained periods (8) and (iii) maintenance of low cutaneous counts and the presence of trace amounts of antibacterial agents which remain on skin after washing have the effect of helping to suppress secondary skin infections (9). Despite the impressive mildness data on soap containing polybromi- hated salicylanilides obtained in standard toxicological tests and human studies, reports of isolated cases of photodermatitis attributed to such soaps are being misconstrued as being more widespread than the facts indicate. One of the soaps mentioned in recent reports (4-6) was Life- buoy •'•*, a product which the authors have examined for some time. It seems appropriate, therefore, to report clinical results which put the photodermatitis data in the proper perspective. EXPERIMENTAL Two standard prophetic patch tests, the Schwartz-Peck and Draize- Shelanski procedures, modified to include UV-irradiation of the treated skin sites, were employed to assess the photosensitizing potential of de- odorant soaps on 150 normal subjects. Over a period of about two months, during which time the patch test series was conducted, the panel members were also given a test bar containing polybrominated salicyl- anilides (test soap B) for regular washing at home and at work. The study was carried out in the vicinity of New York City during the hot, * Lifebuoy is a registered trade name of Lever Brothers Co.
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