Disulfiram-Alcohol Skin Reaction to Beer-Containing Shampoo

David Stoll, MD; Loyd E. King Jr, MD, PhD
JAMA. 1980;244(18):2045. doi:10.1001/jama.1980.03310180015010.
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To the Editor.—  Disulfiram, an inhibitor of acetaldehyde metabolism, is used to discourage alcohol consumption by inducing nausea, vomiting, flushing, and hypotension whenever alcohol is ingested.1 The same symptoms may be produced if a disulfiramtreated patient absorbs alcohol through the skin from colognes, aftershave lotions, sunscreen lotions, and alcohol-based tar gels.2 The following case history illustrates that a commonly available, alcohol-containing shampoo may produce the aldehyde cutaneous reaction in a patient receiving disulfiram.

Report of a Case.—  A 56-year-old man was admitted to the Nashville (Tenn) Veterans Administration Medical Center Alcohol Treatment Program because of chronic alcohol abuse. Except for a contact dermatitic reaction to squash four months before admission, the patient had no skin problems or allergies. Physical examination and admission laboratory values were all unremarkable before starting disulfiram therapy, 250 mg daily at bedtime. Eleven days after disulfiram treatment was started, the patient noted a generalized


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