Pigmented contact dermatitis from azo dyes

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Abstract
Eight patients suffering from pigmented contact dermatitis caused by the commercial Brilliant Lake Red R were patch tested with purified Sudan I and its several chemical analogs. Positive reactions were observed to Sudan I, Orange SS, Brilliant Lake Red R, Vacanceine Red, Yellow OB and Sudan II. Negative patch tests were obtained with Toluidine Red, Permanent Orange, Lithol Red and Sudan III. The commercial Brilliant Lake Red R, which is said to be the most important causative agent of pigmented contact dermatitis, contained Sudan I as a major impurity. The patients reacting to Brilliant Lake Red R always gave a positive reaction to Sudan I, but those reacting to Sudan I did not always give a positive reaction to Brilliant Lake Red R. Sudan I is apparently a potent sensitizer that may induce contact sensitivity; Brilliant Lake Red R itself is a weak sensitizer or a cross-reacting substance. [Many of the discussed substances are used as cosmetic dyes].

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