001033 - Allergic Contact Dermatitis Presenting as Angioedema Following Mesotherapy with Dutasteride

BACKGROUND

Dutasteride is a selective inhibitor of both type 1 and type 2 isoforms of steroid 5 alpha-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone. Dutasteride is indicated for the treatment of benign prostatic hyperplasia. Also, dutasteride can be used to treat hair loss, specifically androgenetic alopecia. Dutasteride is effective for hair loss when administered orally, and mesotherapy (intradermal scalp injections) with it has shown efficacy in real-world studies. Angioedema with oral dutasteride has been reported, a case of allergy contact dermatitis with topical or intradermal dutasteride has also been described.

METHODS

A 28 year-old woman developed swelling and erythema in forehead 12 hours after a first mesotherapy with a product that contained dutasteride, exosomes, copper tripeptide, biotin and B vitamins. The edema gradually spread to the eyelids and malar area over the next 24-48 hours, clearing up completely in 3 to 4 days with treatment. After one month, she was patch tested with T.R.U.E. Test, the product used and dutasteride in alcohol in several concentrations (0.001%, 0.01% and 0.05%). Previously, prick testing was performed with the pure product on the patient and seven healthy controls.

RESULTS AND CONCLUSIONS

There was positive reaction (+) to dutasteride in alcohol in concentration of 0.05% at the 72-hour reading. Prick test with the pure product on the patient and seven healthy controls, were all negatives.

We present a case of allergic contact dermatitis in the form of angioedema caused by dutasteride. Clinical suspicion is needed so that patch tests are performed to achieve a correct diagnosis. The lack of consensus on optimal patch test protocols for dutasteride highlights the need for further research to improve diagnostic accuracy and clinical management in suspected cases of allergic contact dermatitis following mesotherapy.