Contact sensitivity to cigarettes

A 54-year-old woman presented with a 10-month history of erythematous macules and brownish pigmentation on and above the upper lip (Fig. 1). She had itching on her lesions when she had contact with strong fragrance. She had smoked for 10 years. Patch tests were performed with the cigarettes she smoked, a cosmetic she used, the Japanese standard series, a fragrance series, tar and nicotine. Patch tests showed a positive reaction to unsmoked tobacco from the cigarettes. Doubtful (?+) reactions were obtained to smoked tobacco and smoked filter. Unsmoked filter, cigarette paper, another kind of cigarette she did not smoke, tar, nicotine and the cosmetic were negative (Table 1). A patch test to tobacco was negative in five controls. The patient recovered after she stopped smoking.