Allergic contact cheilitis from a lipstick misdiagnosed as herpes labialis: Subsequent worsening due to Zovirax contact allergy

Abstract

A 29-year-old Turkish woman with allergic contact cheilitis from a lipstick was misdiagnosed as herpes labialis and subsequently worsened with the application of Zovirax (R) cream. Patch tests were positive to Zovirax (R) cream, propylene glycol, the patient's favourite lipstick and propyl gallate. No reaction was seen with Zovirax (R) ophthalmic ointment and Zovirax (R) tablet. The propylene glycol component of the Zovirax (R) cream and the propyl gallate component of the lipstick were regarded as the responsible contact sensitizers. The differential diagnosis was challenging due to concomitant contact sensitization with these agents.