The role of 3-dimethylaminopropylamine and amidoamine in contact allergy to cocamidopropylbetaine

Since it has been found that all subjects with contact allergy to cocamidopropylbetaine (CAPB) have positive reactions to 3-dimethylaminopropylamine (DMAPA), and reports have appeared in literature of the sensitizing action of amidoamine in products containing CAPB, we aimed to verify the possibility that pure amidoamine may have a sensitizing role in subjects with positive reactions to CAPB. To this end, in 10 patients with contact allergy to a commercial CAPB, we tested DMAPA 1% aq. and a pure amidoamine in concentrations ranging from 0.5% aq. to 0.1% aq. The study showed that all patients with positive reactions to DMAPA reacted to amidoamine at 0.5% and 0.25% aq., while 4 of the 10 also had positive reactions to amidoamine at 0.1% aq. We consider that simultaneous allergic reaction to DMAPA and amidoamine represents cross-reactivity and hypothesize that DMAPA is in fact the true sensitizing substance, while amidoamine, which may in any case release DMAPA in vivo as a result of enzymatic hydrolysis, may favour the transepidermal penetration of the sensitizing agent. In addition, we advise that testing of CAPB be suspended, because, as suggested by chemico-structural analyses and demonstrated in vivo, when thoroughly purified, it no longer has a sensitizing action.