Hydrogen-Cyanamide-Related Severe Cutaneous Reactions Simulating Erythema multiforme and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Fifteen grapevine workers developed skin reactions resembling erythema multiforme (EM) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) following exposure to Dormex, a plant growth regulator, the active ingredient of which is hydrogen cyanamide. Five patients needed hospitalization, and all recovered following treatment. Whether these were contact EM-like reactions due to hydrogen cyanamide or classical EM, SJS-TEN induced by this chemical remains elusive. An awareness regarding the safe use of agricultural chemicals is needed among the general population.