Sterile cutaneous pustules: A manifestation of primary irritancy? Identification of contact pustulogens

Abstract

An animal model (the rabbit) was used to define which of 8 chemicals caused pustule formation on topical application. Large occlusive chambers (diameter 12 mm), petrolatum as the vehicle and wrapping contributed to efficient occlusion and pustulation. Sodium lauryl sulfate and mercuric chloride gave reproducible results and clear dose-responses indicating that this pustulation is an expression of primary irritancy. Ammonium fluoride pustulation was not reproducible; croton oil pustules were more difficult to evaluate due to simultaneous erythema and edema. Sodium arsentate, nickel sulfate and potassium iodide pustules developed at sites where the skin barriers had been damaged by a stab injury. Benzalkonium chloride caused yellow staining and edema but not pustules. Because of lack of epidemiologic data, the authors do not know how frequently similar findings occur in man.