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Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In many countries, methyl salicylate is available as an analgesic, anti-inflammatory agent, rubefacient and counterirritant in a wide range of over-the-counter liniments, ointments, lotions and medical oils for the self-treatment of muscle pains (11,23). Like other salicylates, methyl salicylate may be absorbed through the intact skin (22) and cause systemic side effects including salicylate intoxication (‘salicylism’). A few examples are presented here, but detailed discussion of the subject is considered to fall outside the scope of this publication.
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In many countries, methyl salicylate is available as an analgesic, anti-inflammatory agent, rubefacient and counterirritant in a wide range of over-the-counter liniments, ointments, lotions and medical oils for muscle pains (7,10). Other uses include or have included in perfumery, (veterinary and human) medications, UV-absorber in sunburn lotions, flavor in foods and beverages, solvent for insecticides, polishes, and inks, and as chemical intermediate (U.S. National Library of Medicine). Cutaneous and non-cutaneous (systemic) side effects of over-the-counter pharmaceutical preparations containing methyl salicylate have been reviewed up to 1996 (8), 2007 (11) and 2019 (12). In this chapter, only contact allergy to methyl salicylate is discussed.
Adverse Effects and Intoxication with Essential Oils
Published in K. Hüsnü Can Başer, Gerhard Buchbauer, Handbook of Essential Oils, 2020
Methyl salicylate is widely available in high concentrations as a component in many over-the-counter brands of ointments, lotions, liniments, rubefacient, and medicated oils intended for topical application to relieve joint and muscular pain (Davis, 2007). Among the most potent forms is wintergreen oil with a content of approximately 98% methyl salicylate. Methyl salicylate in oil of wintergreen is an infrequent cause of salicylate poisoning but is the most dangerous salicylate formulation by strength. One teaspoon of wintergreen oil contains approximately 6 g of methyl salicylate, which is equivalent to approximately 20 aspirin tablets of 300 mg. Childhood fatalities may occur after ingestion of as little as 4 mL of oil of wintergreen (Ellenhorn and Barceloux, 1988); 30 mL of wintergreen oil is equivalent to 55.7 g of aspirin (Johnson, 1985). This conversion illustrates the potency and potential toxicity of oil of wintergreen, even in small quantities. When applied to large areas of skin, topical salicylic acid may cause sufficient dermal absorption to produce toxic serum salicylate levels. Seneviratne et al. (2015) and Lucas (2000) reported four cases of accidental intoxication with small amounts of methyl salicylate, whereof three ended fatally.
Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders
Published in Prehospital Emergency Care, 2020
Joanne Larner, Adam Durrant, Philip Hughes, Devanya Mahalingam, Samantha Rivers, Hazem Matar, Elliot Thomas, Mark Barrett, Andreia Pinhal, Nevine Amer, Charlotte Hall, Toni Jackson, Valeria Catalani, Robert P. Chilcott
In the present study, the clinical efficacy of the aforementioned 3 decontamination methods (dry, ladder pipe, and technical decontamination), alone and in various sequences, was analyzed following the controlled exposure of human volunteers to an aerosolized, semi-volatile simulant. The simulant, methyl salicylate, was mixed with curcumin, a component of turmeric, for fluorescent traceability and with cosmetic-grade mineral oil to suppress volatility by 50%; this was to ensure consistency with a previously reported large-scale exercise (13). Methyl salicylate is a readily available, semi-volatile chemical that has low toxicity and physicochemical properties similar to those of sulfur mustard. It may thus be used to assess both the dermal exposure of casualties and the potential risks from atmospheric inhalation and secondary exposure. Consequently, it has a long history of use in studies of this type and for the evaluation of protective clothing (24, 25). The fluorescent property of curcumin enables it to be visualized under near-UV light. Incorporation of such fluorescent tracers into simulants is commonly used for research into washing efficacy and dermal exposure (26, 27).
Decontamination efficacy of soapy water and water washing following exposure of toxic chemicals on human skin
Published in Cutaneous and Ocular Toxicology, 2020
Emma Forsberg, Linda Öberg, Elisabet Artursson, Elisabeth Wigenstam, Anders Bucht, Lina Thors
To evaluate the time window for efficient decontamination, washing with water or soapy water was initiated 5, 15, 45, and 120 min after exposure. For all test substances, it was clearly demonstrated that decontamination had greater efficacy when initiated at the earliest time-point. Delayed decontamination to 120 min showed low efficacy resulting in a significant amount of agent penetrating the skin, but notably a significant reduction of penetrated compound through the skin was observed for ethyl lactate, methyl salicylate, and tributylamine. The importance of early initiated decontamination following skin exposure to chemicals has frequently been reported52–54. It should also be noted that for methyl salicylate, a temporary increase in penetration rate was observed directly following the washing procedure and a similar effect was observed for 2-butoxyethanol but only after washing with soapy water. This effect might be due to increased skin permeability induced by washing with water and soap, as previously described for other chemical compounds55–57. The underlying mechanisms of this “wash-in” effect are likely tissue hydration and eventually soap may enhance “wash-in” of substances by surfactant effects and pH changes55–57. It is suggested that the “wash-in” effect depends on chemical identity and elapsed time between exposure and onset of the washing procedure55–57, but no prediction model for which chemicals that attains enhanced penetration following wet decontamination has been presented.
An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1
Published in South African Family Practice, 2019
Topical NSAIDs have the same mechanism of action as the systemic formulations. Penetration through the skin to the site of inflammation leads to a more focused site of drug action. Systemic absorption and subsequent adverse effects are lessened with topical preparations, but these systemic effects should always be borne in mind when prescribing topical NSAIDs. A recently updated Cochrane Review32 comparing 16 topical NSAIDs to placebo for clinically significant acute musculoskeletal pain relief found that diclofenac, ketoprofen, and ibuprofen were most effective (number needed to treat [NNT] of less than 4). All other topical NSAIDs had an NNT of greater than 4, indicating lesser efficacy. Topical NSAIDs were also more efficacious in mild to moderate acute pain conditions, with limited effect in chronic musculoskeletal pain. In another Cochrane Review33 the salicylate preparations, such as methyl salicylate, showed conflicting evidence, with the older, smaller studies indicating efficacy, whereas the newer, larger trials did not.