Hypomelanosis From an Antioxidant in Polyethylene Film

To the Editor.—  Hypomelanosis from an antioxidant in polyethylene film was recently reported in the Archives by Vollum (104:70-72, 1971). Two Negro children were described who developed hypomelanosis associated with prolonged occlusive steroid therapy.The author indicates that the leukoderma was secondary to butylated hydroxytoluene (BHT) which Dr. Vollum admits is commonly used in plastics and edible fats but is not known to be a common sensitizer. The polyethylene film does not contain any hydroquinones or other depigmenting agents.An inconsistency appears when the author states that comparison of the two polyethylene formulas shows that BHT is not related chemically to monobenzone (a well-known depigmenting agent). "It seems likely, therefore, that BHT was responsible for the hypomelanosis."Patch tests were performed with 0.5%, 1%, and 5% BHT although the concentration of BHT in polyethylene film is only 0.02%. Despite the failure to reproduce the clinical picture, the author