{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:04:24Z","timestamp":1791572664960,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,12,5]],"date-time":"2011-12-05T00:00:00Z","timestamp":1323043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Skin Research and Technology"],"published-print":{"date-parts":[[2012,8]]},"abstract":"Background<\/jats:title>Quaternary ammonium compounds (Quats), such as benzalkonium chloride (BAC<\/jats:styled-content>) and benzethonium chloride (BEC<\/jats:styled-content>), are widely used as antibacterial active ingredients and preservatives in personal care products, disinfectants, and ophthalmic preparations. BAC<\/jats:styled-content> is known to be a marginal irritant when patch tested at 0.15% aq. Data on BEC<\/jats:styled-content> are limited.<\/jats:p><\/jats:sec>Objective<\/jats:title>To differentiate irritant from allergic patch test reactions to quaternary ammonium compounds.<\/jats:p><\/jats:sec>Methods<\/jats:title>Eight subjects who were considered likely to react based on history of rash after exposure to disinfectants or a history of prior positive patch test to BAC<\/jats:styled-content> were recruited, as well as two patients undergoing routine patch testing. BAC<\/jats:styled-content> (0.15% aq), BAC<\/jats:styled-content> (0.15% pet), BEC<\/jats:styled-content> (0.05% aq), BEC<\/jats:styled-content> (0.15% pet), BEC<\/jats:styled-content> (0.15% aq), BEC<\/jats:styled-content> (0.5% aq), sodium lauryl sulfate (2.0%), and deionized water were applied under F<\/jats:styled-content>inn chambers for 48\u00a0h. Four days and 7\u00a0days after application, the sites were examined visually and then by in vivo<\/jats:italic> reflectance confocal microscopy (RCM<\/jats:styled-content>) which was interpreted by blinded experts.<\/jats:p><\/jats:sec>Results<\/jats:title>Two patients with definite allergic reactions according to visual patch test reads and RCM<\/jats:styled-content> were clinically relevant. Cross\u2010reaction between BEC<\/jats:styled-content> and BAC<\/jats:styled-content> was demonstrated in one patient. RCM<\/jats:styled-content> imaging correlated well with clinical scoring and interpretation of patch test reactions in terms of irritancy vs. allergy for BEC<\/jats:styled-content> and BAC<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Relevant allergic reactions to quats occur in humans. Possible cross\u2010reaction was noted to occur between BAC<\/jats:styled-content> and BEC<\/jats:styled-content>. RCM<\/jats:styled-content> appears to be a useful tool in distinguishing between irritancy and sensitization during patch testing to BAC<\/jats:styled-content> and BEC<\/jats:styled-content>. Further study of prevalence and best test concentration and vehicle is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1600-0846.2011.00577.x","type":"journal-article","created":{"date-parts":[[2011,12,6]],"date-time":"2011-12-06T02:50:25Z","timestamp":1323139825000},"page":"272-277","source":"Crossref","is-referenced-by-count":19,"title":["Visual and confocal microscopic interpretation of patch tests to benzethonium chloride and benzalkonium chloride"],"prefix":"10.1111","volume":"18","author":[{"given":"Bohaty","family":"Benjamin","sequence":"first","affiliation":[{"name":"Akron General Medical Center Department of Medicine Akron OH USA"},{"name":"University Hospitals Case Medical Center Department of Dermatology Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fricker","family":"Chris","sequence":"additional","affiliation":[{"name":"GOJO Industries Inc. 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