Contact dermatitis with clostridiopeptidase A contained in Noruxol ointment

Contact Dermatitis. 2007 Jun;56(6):361-2. doi: 10.1111/j.1600-0536.2006.01056.x.

Abstract

Clostridiopeptidase A, also called collagenase 1, is a proteolytic enzyme capable of digesting collagen. Preparations containing clostridiopeptidase A are used topically for the debridement of dermal ulcers, burns and other necrotic lesions to facilitate the formation of granulation tissue and subsequent epithelization. We observed 4 patients with a periulcerative eczema after repeated applications of Noruxol ointment (Smith & Nephew Ltd, L Hull, UK). Patch testing with Noruxol ointment as is and its excipients (soft paraffin and white petrolatum), as well as scaled dilutions of the main ingredient of this topical preparation, clostridiopeptidase A (Firma, Florence, Italy), showed doubtful reactions to Noruxol ointment in 3 patients and a positive reactions only in 1 patient. All patients showed positive reactions to clostridiopeptidase A 1% in pet. This study shows the sensitizing capacity of clostridiopeptidase A that should be tested in all patients with suspect sensitization to Noruxol ointment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Burns / drug therapy
  • Debridement / methods
  • Dermatitis, Allergic Contact / diagnosis*
  • Dermatitis, Allergic Contact / etiology*
  • Dermatologic Agents / adverse effects*
  • Female
  • Humans
  • Microbial Collagenase / adverse effects*
  • Ointments / adverse effects
  • Patch Tests
  • Skin Ulcer / drug therapy

Substances

  • Dermatologic Agents
  • Ointments
  • Microbial Collagenase