Australasian Journal of Dermatology (2012) 53, 76–77
BRIEF REPORT
Allergic contact dermatitis caused by a cell phone cover
Penelope Jane Williams, Clodagh King and Vicky Arslanian
Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals, NHS Trust, Liverpool,
United Kingdom
ABSTRACT
We describe a case of contact dermatitis to a phone
cover, which was compounded by secondary allergic
contact dermatitis to topical creams used. The phone
cover was advertised as being composed of silicone
only. Patch testing with the cover material confirmed
the diagnosis. In addition, there were positive patch
test reactions to a number of allergens in the plastics
and glues series from Chemotechnique Diagnostics
(Malmö, Sweden). The increasing use of phone
covers and the multiple positive reactions to chemi-
cals used in plastic manufacture seen in this case
suggest that similar allergic reactions may occur
more frequently in the future and should be consid-
ered in the differential diagnosis of facial dermatitis.
Key words: cell phone, cell phone cover, contact
allergy.
INTRODUCTION
Allergic contact dermatitis caused by contact with the nickel
in cell phones has been widely reported and is now well
recognized and quite common.1–3
However, with more expensive cell phones being intro-
duced into the market, consumers are also purchasing pro-
tective cell phone covers and while this may, among other
things, prevent contact with nickel, the chemicals used in
the manufacture of the case may also be allergens. This
paper describes a case of allergic contact dermatitis to a cell
phone cover, described as a single piece of silicone.
Correspondence: Dr Penelope Jane Williams, Royal Liverpool and
Broadgreen University Hospital, Dermatology, Liverpool, United
Kingdom. Email: penster50@hotmail.com
Penelope Jane Williams, MRCP. Clodagh King, FRCP. Vicky
Arslanian, RGN.
Submitted 21 June 2011; accepted 22 June 2011.
© 2011 The Authors
Australasian Journal of Dermatology © 2011 The Australasian College of Dermatologists
doi: 10.1111/j.1440-0960.2011.00801.
ajd_801 76..77
CASE HISTORY
A 30-year-old right-handed woman with a background of
atopic eczema and a known allergy to costume jewellery,
presented with an acute vesicular rash on the right cheek
which occurred 7 days after purchasing a flexible silicone
cover for her mobile phone. There was no history to suggest
that she had previously been sensitized to plasticisers. She
had previously used the same phone for some time without
incident. The eczematous rash initially developed in a
linear, well-demarcated area on the lower cheek which
corresponded to the edge of the phone cover in contact with
the skin (Fig. 1). She applied Eucerin cream (Beiersdorf AG,
Hamburg, Germany) and E45 (Reckitt Benckiser Products
Ltd, Humberside, UK) cream to the rash but it then spread
to involve both cheeks, the nasal bridge, front and right side
of her neck.
The patient was patch tested with the British Contact
Dermatitis Society standard series, the Plastics and Glues
series, the Rubber Additives Series (Chemotechnique Diag-
nostics, Malmö, Sweden) and with wet (soaked in saline)
and dry samples of the phone cover. The allergens were
applied to her back using Inert Quadrate & Ideal Quick test
chambers (Chemotechnique Diagnostics) and readings
were done in accordance with the International Contact
Dermatitis Research Group criteria at D2, D4 and D7. Posi-
tive reactions to the cell phone cover were seen (Fig. 2), as
were reactions to tricresyl phosphate, phenol formalde-
hyde, PTBC (p-tert-butyl-catechol), amerchol L101 and
wool alcohols (Table 1).
She discarded the cell phone cover; treatment with
Fucibet (Leo Pharma, Buckinghamshire, UK; containing
betamethasone and fusidic acid) cream and oral predniso-
lone 40 mg daily for 7 days cleared the eczematous rash.
She has continued to use the phone without the cover and
the rash has not reoccurred.
DISCUSSION
The patch test readings to the ‘silicone’ cover were strong
(2+) and were maintained through the 7 day assessment,
therefore confirming allergy to a component or components
of the cover.
On the other hand, in the Chemotechnique Plastics and
Glues Series reactions to tricresyl phosphate diminished at
 Allergic contact dermatitis 77

Table 1 Positive patch tests at D2, D4 and D7

D2 D4 D7

Dry phone cover ++ ++ ++

Wet phone cover ++ ++ ++
Tricresyl phosphate ++ + +
Phenol formaldehyde ++ ++ +
PTBC (p-tert-Butyl-catechol) ++ ++ ⫾
Amerchol L101 + + ⫾
Wool alcohols ++ ++ +

Figure 1 Eczematous rash with delineation corresponding to
contact with the cell phone cover.
Figure 2 Patch test results to the wet and dry phone cover at D4.
D4 (patch removed at D2) which suggests that this might
have had an irritant effect and therefore was of question-
able relevance to the contact allergy to the cover.
The company informed the patient that the Griffin Flex-
Grip Punch (Griffin Technology, Nashville, TN, USA) cover
contained polydimethylvinylsiloxane silicon dioxide and
hydroxyl-terminated silicone oil, but were unable to provide
further information on the glues and plasticisers used.
However since silicone is rarely a sensitizer4 and the
chemicals to which positive patch tests were seen are com-
monly used in the manufacture of plastics, it seems likely
that one or more of them are implicated as the cause of the
dermatitis but this must remain speculative.
The initial rash occurred on the part of the patient’s right
cheek where she rested her phone but then spread over her
face and down the right side of her neck. The patient had
applied both Eucerin cream (containing 5–10% urea, benzyl
alcohol, light liquid paraffin, sodium lactate solution,
magnesium stearate, microcrystalline wax, triglyceride
diisostearate, isopropyl palmitate, wool alcohols) and E45
(containing light liquid paraffin, white soft paraffin, hypoal-
lergenic anhydrous lanolin, empilan GMS, cetyl alcohol,
sodium cetostearyl sulphate, propyl hydroxybenzoate,
sodium hydroxide, citric acid monohydrate) cream to
these areas three times daily for several days. She had a
strong positive reaction to wool alcohols (lanolin) and a
weak reaction to Amerchol 101, a cosmetic product contain-
ing lanolin alcohols. Therefore concomitant allergy to
lanolin played a part in the severity and extension of the
eczematous rash on her face and neck.
Autosensitization may also have played a role in the
extension of the rash beyond the contact area of the cell
phone cover.
The patient also suffered from atopic dermatitis and this
may be an alternative explanation for the rash elsewhere.
To date there have been several reports of contact derma-
titis to mobile phones, including allergic reactions to nickel
and chromate1–3,5–7 but, as far as we know, this is the first
report of allergic contact sensitivity to an phone cover.
However, with the increasing use of cell phone covers and
the longer periods of skin contact as a result of unlimited
usage plans, it is likely that more cases will be seen.
In conclusion, allergy to a cell phone cover has been
proven, but allergy to silicone is rare4 and the actual allergic
component (possible manufacturing additive) has not been
detected.
REFERENCES
1. Pazzaglia M, Pasquale L, Colombina V et al. Contact dermatitis
from nickel in mobile phone. Contact Dermat. 2000; 42: 362–3.
2. Luo J, Bercovitch L. Cellphone contact dermatitis with nickel
allergy. CMAJ 2008; 178: 23–4.
3. Roberts H, Tate B. Nickel allergy presenting as mobile phone
contact dermatitis. Australas. J. Dermatol. 2010; 51: 23–5.
4. Puri S, Dornhoffer JL, North PE. Contact dermatitis to silicone
after cochlear implantation. Laryngoscope 2005; 115: 1760–2.
5. Seishima M, Oyama Z, Makiko O. Cellular phone dermatitis
with chromate allergy. Dermatology 2003; 207: 48–50.
6. Rajpara A, Feldman SR. Cell phone allergic contact dermatitis:
case report and review. Dermatol. Online J. 2010; 16: 9–A.
7. Guarneri F, Guarneri C, Patrizia Cannavò S. An unusual case of
cell phone dermatitis. Contact Dermat. 2010; 62: 117.

© 2011 The Authors

Australasian Journal of Dermatology © 2011 The Australasian College of Dermatologists