INTRODUCTION
Poppers are psychoactive inhalants commonly employed in the gay male community for their ability to relax anal sphincter muscles.1 These drugs induce numerous adverse effects including dizziness, retinal degeneration, headache, maculopathies, fatal methemoglobinemia, and contact dermatitis.2,3 Poppers are formulated with volatile alkyl nitrite compounds that nitrate aromatic amino acids in the skin through a xanthoprotein reaction, causing irritant contact dermatitis (ICD).4 Exposure to poppers after previous sensitization has also been shown to induce allergic contact dermatitis (ACD).4 While there are scattered reports on their role in contact dermatitis, there is limited information pertaining to clinical presentation and management strategies, resulting in potential gaps in care. Given these limitations, the authors sought to collate and review the 13 published case reports on poppers dermatitis to better prepare dermatologists to identify and manage this emerging source of ACD and ICD.
MATERIALS AND METHODS
A comprehensive literature search was conducted on PubMed, Google Scholar, and Scopus to identify all published cases of poppers contact dermatitis. Search terms included 'dermatitis' and 'poppers' or 'alkyl nitrites' or 'amyl nitrites' or 'isobutyl nitrites' or 'propyl nitrites'. Date, geographical, and language restrictions were not employed. Full text of 2 case reports could not be accessed and were excluded. Factors chosen for extraction were age, gender, type of alkyl nitrite, men who have sex with men (MSM) association, time to reaction onset, morphological characteristics, diagnosis of contact dermatitis (allergic, irritant, both, or neither), patch testing completion, lesion location, and treatments. Independent samples t-tests were performed using SPSS Version 26. A PRISMA flow diagram was constructed to summarize the process of data extraction (Figure 1).
