Clinical sequelae associated with squaric acid dibutylester topical sensitization

image Squaric acid dibutylester (SADBE) is a potent topical sensitizer used in the treatment of various cutaneous conditions. Currently, there are no standardized protocols defining safe sensitization methods or treatment regimens following sensitization. image This is a literature review of the clinical use of SADBE and a report of our experience with SADBE therapy and its potential hazards. image SADBE was applied with a cotton swab to the forearm of 14 patients to induce contact dermatitis. image Ten of 14 patients (71%) had severe eczematous reactions at the site of sensitization, and 9 of 14 (64%) developed disseminated reactions. image Standard protocols delineating safe methods of sensitization and treatment with SADBE need further development.