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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 115-116

Contact urticaria to thrombophob gel


1 Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
2 Division of Immunohematology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India

Date of Submission20-Apr-2021
Date of Acceptance04-May-2021
Date of Web Publication29-May-2021

Correspondence Address:
Dr. Abhishekh Basavarajegowda
Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gjtm.gjtm_31_21

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How to cite this article:
Basavarajegowda A, Anand D, Krishnappa P. Contact urticaria to thrombophob gel. Glob J Transfus Med 2021;6:115-6

How to cite this URL:
Basavarajegowda A, Anand D, Krishnappa P. Contact urticaria to thrombophob gel. Glob J Transfus Med [serial online] 2021 [cited 2021 Jun 25];6:115-6. Available from: https://www.gjtmonline.com/text.asp?2021/6/1/115/317130



Sir,

Thrombophob is the trade name of gel of heparin and benzyl nicotinate (50 IU: 2 mg) and sorbic acid as a preservative manufactured and marketed by Cadila, India. It is prescribed to help manage various conditions such as circulation in conditions such as phlebitis,[1] thrombophlebitis, varicose veins, bedsores, haemorrhoids, sprains, strains, contusions, grass burns, hematomas, and scars.[1],[2]

Heparin inhibits thrombin formation, promotes fibrinolysis, and helps in the absorption of the more superficial microthrombi. Benzyl nicotinate by vasodilatation enhances local heparin absorption.

It is used in the blood bank to accelerate hematoma clearance in donors after phlebotomy if at all occurs, which is common depending on the phlebotomist's technique. Erythema and redness of the applied area are quite common due to the very mechanism of action of benzyl nicotinate, but allergic reactions are infrequent and hardly reported, if any.

Hereby, we report a case of such a reaction that was noticed when it was applied postphlebotomy on a first time donor who had postdonation swelling around the phlebotomy area. The donor was 19 years of age and did not have any history of allergic disorders in the past or allergic reactions to the drugs. The donor developed well-defined erythematous, edematous wheals at the site of thrombophob ointment application [Figure 1].
Figure 1: (a and b) Urticarial lesions noted at site of Thrombophob application

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The lesions disappeared completely within 2 h. There were no postlesion sequelae or symptoms with follow-up after 48 h. There are no data on the efficacy of thrombophob nor its adverse effects. Both heparin and benzyl nicotinate are known to cause urticaria.[3] A patch test with both the components and other preservatives in the gel may help us decipher what is actually responsible for the urticaria. However, from the viewpoint of phlebotomists and blood center personnel, it is imperative to be aware of this event to counsel and comfort the donors if it is noticed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Saini B, Paul P. Effectiveness of cold application, heparinoid application and magnesium sulphate application on superficial thrombophlebitis among patients. Ind J N Stud 2011:2;4-10.  Back to cited text no. 1
    
2.
Kamlesh S, Kuldeep P. Evaluate the effectiveness of cold compress, versus magnesium-sulphate application on superficial thrombophlebitis among patients admitted in selected hospital Udaipur, Rajasthan. Int J Appl Res 2020;6:242-6.  Back to cited text no. 2
    
3.
Wütschert R, Piletta P, Bounameaux H. Adverse skin reactions to low molecular weight heparins: Frequency, management and prevention. Drug Saf 1999;20:515-25.  Back to cited text no. 3
    


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