Histiocytic reaction associated with topical aluminum chloride (Drysol reaction)

Abstract

Background: In the past few years, dermatologists have begun to use aluminum chloride (Drysol) as a hemostatic agent for minor surgical procedures. An unusual histiocytic reaction was noted in biopsies of skin previously treated with aluminum chloride. This reaction consisted of a proliferation of histiocytic cells that contained prominent basophilic cytoplasmic granules.

Objective: To determine the cause of this reaction and the nature of the basophilic granular material within the histiocytic cells.

Methods: Four cases are presented in which re-excised tissue previously treated with aluminum chloride were examined with special histochemistry staining and roentgen diffraction studies.

Results: The granules of these histiocytes stained positively with the aluminon stain, a stain specific for aluminum, although no aluminum was found using the less sensitive roentgen diffraction studies.

Conclusion: These studies support the concept that aluminum chloride can cause a proliferative histiocytic reaction when used as a topical cauterizing agent.