Sofa Rash Guide for General Practitioners

Written by Prof David J Gawkrodger

Patients with sofa dermatitis present with an odd red often swollen and scaly intensely itchy severe rash at body sites where there has been contact between bare skin and the leather sofa, usually the arms, body or legs. The rash may occur when skin has been covered and can be unilateral.

The connection between sitting on a newly acquired leather sofa and the rash is often not made at first because the eruption is not a typical contact dermatitis. The rash shows more inflammation, is more widespread and more persistent than is normal for a contact allergy.

The rash often does not respond well to treatment, even with highly potent topical steroids. In some patients, the eruption has been severe enough to warrant hospital admission and systemic steroids.

Affected patients started to present in late 2006. Over 5000 have been recognized in the UK. New cases are still being diagnosed.

The causative agent appears to be a fungicide, dimethyl fumarate(1). This is placed in sachets within the sofas or chairs during manufacture to prevent mould growth on the leather. The chemical penetrates the sofa fabric in hot conditions and deposits on the leather, from where it acts as a potent sensitizer and induces dermatitis.

GPs who suspect sofa dermatitis that does not settle with standard treatments of emollients and topical steroids, are advised to contact their local Department of Dermatology for advice.

Reference

1. Rantanen T. The cause of the Chinese sofa/chair dermatitis epidemic. Br J Dermatol 2008;159:218-21.

Prof David J Gawkrodger
Consultant Dermatologist
Royal Hallamshire Hospital
Sheffield
26th July 08

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