Airborne allergic contact dermatitis from tylosin in pharmacy compounders and cross-sensitization to macrolide antibiotics.

Tylosin is a broad-spectrum macrolide antibiotic that is restricted to veterinary use. Allergic contact dermatitis (ACD) caused by tylosin has been reported in the literature from the farming industry and veterinary medicine. It is also reported as the most common antibiotic to cause ACD in the previously mentioned occupational settings. We present 2 cases of airborne ACD from tylosin among veterinary pharmaceutical compounding technicians. To our knowledge, only one other case of patch test-confirmed tylosin ACD has been reported in the manufacturing setting. Based on our results, cross-sensitization to other clinically relevant macrolides does not appear to be a concern. Our cases highlight the importance of patch testing among pharmaceutical compounders where the incidence of an airborne contact may be greater, given that the exposure is to the powdered form of potential allergens.