ABSTRACT
Topical diltiazem creams are used to treat anal fissures and Raynaud's syndrome. A few cases of allergic contact dermatitis to diltiazem cream used for anal fissures have been described. The resorption of diltiazem through the perianal skin and the mucosa has led to systemic contact dermatitis presenting as generalized (maculo-)papular rashes and the baboon syndrome. Patch tests were positive to diltiazem gel and negative to its preservative methylparaben; the excipients sorbitol and hypromellose were not tested, as they were not considered possible allergens. A patient sensitized to diltiazem co-reacted to 2 other calcium channel blockers, nifedipine and verapamil HCl. In the period 2004-2005, in a Spanish multicenter study performing photopatch testing, 2 relevant positive photopatch tests were observed to diltiazem.
