Antibiotic polypeptide complex produced by Bacillus subtilis widely used as topical antibacterial medication.
Immediate allergy is infrequent (10 cases reported)
Contact dermatitis is common.
Compromised skin barrier (leg ulcers, excoriated dermatitis, burns).
Usually severe: anaphylactic shock with hypotension (80%) pruritus, flush,
swelling of the tongue and face,
Skin prick-tests positive in a few cases of anaphylaxis (intradermal skin-tests may be dangerous).
Positive patch-tests in contact dermatitis.
Strong evidence of IgE-mediated hypersensitivity including positive immediate skin tests, positive Prausnitz-Küstner tests, although IgE antibodies have not been disclosed by other methods.