Efeitos da intoxicação por <i>slime</i> em crianças e adolescentes

Entre janeiro e julho de 2021, ocorreu a seleção dos artigos, utilizando-se as bases de dados: United States National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Foram utilizados os seguintes descritores: (dermatitis OR rash OR eczema OR inflammation) AND slime. Incluíram-se artigos disponíveis na íntegra, em português, inglês ou espanhol, publicados entre janeiro de 2000 e 31 julho de 2021, que relatassem casos de crianças e adolescentes que apresentaram reação cutânea após a manipulação do brinquedo slime. Foram excluídos artigos sem aderência ao tema e textos duplicados nas bases de dados.

Síntese dos dados:

Identificaram-se 65 publicações, sendo 16 utilizadas para a elaboração desta revisão. Isso resultou no total de 22 crianças (duas do sexo masculino, 20 do feminino), com idades entre quatro e 13 anos, que teriam sido intoxicadas por slime, a maioria dos casos ligado a preparações caseiras. Estudos relataram a ocorrência de dermatite de contato ou alérgica nas mãos, dedos, unhas, antebraços e bochechas. Os ingredientes mais alergênicos e/ou irritantes foram detergentes líquidos e sabão. Ademais, o patch test identificou reações positivas para metilisotiazolinona e metilcloroisotiazolinona, que são conservantes utilizados em produtos como cola, sabão, detergente, etc.

Conclusões:

Ainda que o brinquedo slime seja importante para o desenvolvimento motor e das relações parentais, receitas caseiras incluem vários ingredientes alergênicos e irritantes, que podem ser expostos a crianças vulneráveis e causar intoxicações. Sendo assim, as preparações do slime devem ser feitas com cautela e sob supervisão de adultos.

Palavras-chave:
Dermatite alérgica de contato; Dermatite irritante, Jogos e brinquedos; Testes do emplastro; Criança

Author, year, country	Age and Sex	Atopy	Site of allergic reaction	Type of reaction
Zhang et al.¹³13. Zhang AJ, Boyd AH, Asch S, Warshaw EM. Allergic contact dermatitis to slime: the epidemic of isothiazolinone allergy encompasses school glue. Pediatr Dermatol. 2019;36:e37-8. https://doi.org/10.1111/pde.13681 https://doi.org/10.1111/pde.13681... (2019), USA	10, F	N/I	Distal dorsal and palmar fingers	ACD
Kondratuk et al.¹⁴14. Kondratuk KE, Norton SA. “Slime” dermatitis, a fad-associated chronic hand dermatitis. Pediatr Dermatol. 2019;36:e39-40. https://doi.org/10.1111/pde.13729 https://doi.org/10.1111/pde.13729... (2019), USA	12, F	Yes	Dorsal right hand and wrist	Chronic dermatitis
	13, F	N/I	Both palms	Contact dermatitis
Heller et al.¹⁵15. Heller E, Murthy AS, Jen MV. A slime of the times: two cases of acute irritant contact dermatitis from homemade slime. Pediatr Dermatol. 2019;36:139-41. https://doi.org/10.1111/pde.13617 https://doi.org/10.1111/pde.13617... (2019), USA	7, F	N/I	Both palms	ICD
	10, F	N/I	Both palms	ICD
Ducharme et al.¹⁶16. Ducharme O, Labadie M, Briand SM, Milpied B. Allergic contact dermatitis in a child caused by isothiazolinones in a “noise putty”. Contact Dermatitis. 2018;79:393-4. https://doi.org/10.1111/cod.13096 https://doi.org/10.1111/cod.13096... (2018), France	7, M	No	Fingertips	Eczema
Gittler et al.¹⁷17. Gittler JK, Garzon MC, Lauren CT. “Slime” may not be so benign: a cause of hand dermatitis. J Pediatr. 2018;200:288. https://doi.org/10.1016/j.jpeds.2018.03.064 https://doi.org/10.1016/j.jpeds.2018.03.... (2018), USA	9, F	N/I	Palmar surfaces of both hands and volar fingertips	Pruritic dermatitis
Aerts et al.¹⁸18. Aerts O, De Fré C, van Hoof T, Ghys K, Ortopelea RA, Lambert J. “Slime”: a new fashion among children causing severe hand dermatitis. Contact Dermatitis. 2018;79:385-7. https://doi.org/10.1111/cod.13090 https://doi.org/10.1111/cod.13090... (2018), Belgium	11, F	No	Palmar vesicular	Severe vesicular dermatitis
	9, M	Yes	Hands	Vesicular dermatitis
Piazza et al.¹⁹19. Piazza CD, Cestari SC. Contact dermatitis from do-it-yourself slime. An Bras Dermatol. 2018;93:944. https://doi.org/10.1590/abd1806-4841.20188396 https://doi.org/10.1590/abd1806-4841.201... (2018), Brazil	11, F	N/I	Dorsal region of the six fingers	Contact dermatitis
Tehrany et al.²⁰20. Tehrany YA, Quenan S, Bugey A, Piletta P. Contact dermatitis caused by homemade “slime”: report of two cases with chemical analysis. Contact Dermatitis. 2019;80:407-8. https://doi.org/10.1111/cod.13230 https://doi.org/10.1111/cod.13230... (2019), Switzerland	12, F	No	Both palms and extension to the forearms and face	Eczema
	11, F	Yes	Hands	Severe dermatitis
Anderson et al.²¹21. Anderson LE, Treat JR, Brod BA, Yu J. “Slime” contact dermatitis: case report and review of relevant allergens. Pediatr Dermatol. 2019;36:335-7. https://doi.org/10.1111/pde.13792 https://doi.org/10.1111/pde.13792... (2019), USA	11, F	Yes	Hands and cheeks	Atopic dermatitis
Salman et al.²²22. Salman A, Demir G, Apti O. “Slime”: a trending cause of isothiazolinone contact allergy in children. Contact Dermatitis. 2019;80:409-11. https://doi.org/10.1111/cod.13237 https://doi.org/10.1111/cod.13237... (2019), Turkey	9, F	No	Hand, fingers, and periunguium	Dermatitis
	12, F	N/I	Both palms	Dermatitis
	10, F	N/I	Hands, on the sides of fingers	Eczema
Mainwaring et al.²³23. Mainwaring W, Zhao J, Hunt R. Allergic contact dermatitis related to homemade slime: a case and review of the literature. Dermatol Online J. 2019;25:13030/qt7n06w0hg. PMID: 31046914 (2019), USA	11, F	Yes	Bilateral palms and fingers	Dyshidrotic eczema, ICD, and ACD
Kong and Lam²⁴24. Kong C, Lam JM. Slime dermatitis. CMAJ. 2019;191:E536. https://doi.org/10.1503/cmaj.181511 https://doi.org/10.1503/cmaj.181511... (2019), Canada	10, F	N/I	Palmar surfaces of hands and fingertips	Contact dermatitis
Pessotti et al.²⁵25. Pessotti NS, Hafner MF, Possa MS, Lazzarini R. Allergic contact dermatitis to slime. An Bras Dermatol. 2020;95:265-6. https://doi.org/10.1016/j.abd.2019.06.008 https://doi.org/10.1016/j.abd.2019.06.00... (2020), Brazil	9, F	Yes	Palmar surface	ACD
Córdoba et al.²⁶26. Córdoba S, Blanco-Calvo M, Huerta-Vena A, Borbujo J. Allergic contact dermatitis due to slime. Actas Dermosifiliogr (Engl Ed). 2021;112:285-7. https://doi.org/10.1016/j.ad.2020.03.006 https://doi.org/10.1016/j.ad.2020.03.006... (2021), Spain	10, F	No	Palms, interdigital folds, dorsal, and sides of the hands	ACD
Saad et al.²⁷27. Saad S, Lahouel I, Belhadjali H, Kheder A, Youssef M, Zili J. “Hand-borne” allergic contact dermatitis of the face to slime, possibly photoaggravated. Contact Dermatitis. 2020;82:329-30. https://doi.org/10.1111/cod.13475 https://doi.org/10.1111/cod.13475... (2020), Tunisia	13, F	N/I	Face (cheeks) and hands	ACD
Brazen et al.²⁸28. Brazen BC, Wehausen B, Usmani AA. Not all fun and games: a case report of contact dermatitis related to slime and play-doh. Cureus. 2020;12:e10272. https://doi.org/10.7759/cureus.10272 https://doi.org/10.7759/cureus.10272... (2020), USA	4, F	N/I	Hands and thighs	Pruritic rash

Author, year, country	Slime ingredients	Slime type	Allergens in potential	Dermatologic test
Zhang et al.¹³13. Zhang AJ, Boyd AH, Asch S, Warshaw EM. Allergic contact dermatitis to slime: the epidemic of isothiazolinone allergy encompasses school glue. Pediatr Dermatol. 2019;36:e37-8. https://doi.org/10.1111/pde.13681 https://doi.org/10.1111/pde.13681... (2019), USA	Glue, shaving cream, and contact lens solution	Homemade	MCI/MI	Patch test
Kondratuk et al.¹⁴14. Kondratuk KE, Norton SA. “Slime” dermatitis, a fad-associated chronic hand dermatitis. Pediatr Dermatol. 2019;36:e39-40. https://doi.org/10.1111/pde.13729 https://doi.org/10.1111/pde.13729... (2019), USA	Homemade nonborax slime	Homemade	N/I	N/I
	N/I	N/I	N/I	N/I
Heller et al.¹⁵15. Heller E, Murthy AS, Jen MV. A slime of the times: two cases of acute irritant contact dermatitis from homemade slime. Pediatr Dermatol. 2019;36:139-41. https://doi.org/10.1111/pde.13617 https://doi.org/10.1111/pde.13617... (2019), USA	Tide with bleach, glue, and water, as well as marker for color	Homemade		N/I
	Glue, baking soda, shaving cream, contact lens solution, and food coloring	Homemade	N/I	N/I
Ducharme et al.¹⁶16. Ducharme O, Labadie M, Briand SM, Milpied B. Allergic contact dermatitis in a child caused by isothiazolinones in a “noise putty”. Contact Dermatitis. 2018;79:393-4. https://doi.org/10.1111/cod.13096 https://doi.org/10.1111/cod.13096... (2018), France	Polyvinyl alcohol, glycerin, borax, ethyl paraben, deionized water, and various dyes	Manufactured	MCI/MI	Patch test
Gittler et al.¹⁷17. Gittler JK, Garzon MC, Lauren CT. “Slime” may not be so benign: a cause of hand dermatitis. J Pediatr. 2018;200:288. https://doi.org/10.1016/j.jpeds.2018.03.064 https://doi.org/10.1016/j.jpeds.2018.03.... (2018), USA	N/I	Homemade	N/I	N/I
Aerts et al.¹⁸18. Aerts O, De Fré C, van Hoof T, Ghys K, Ortopelea RA, Lambert J. “Slime”: a new fashion among children causing severe hand dermatitis. Contact Dermatitis. 2018;79:385-7. https://doi.org/10.1111/cod.13090 https://doi.org/10.1111/cod.13090... (2018), Belgium	Textile glue, household detergents, and (food) colorants	Homemade and manufactured	MCI/MI, MDBGN	Patch test
	N/I	Manufactured	Paraben mix (methyl and ethyl paraben)	Patch test
Piazza et al.¹⁹19. Piazza CD, Cestari SC. Contact dermatitis from do-it-yourself slime. An Bras Dermatol. 2018;93:944. https://doi.org/10.1590/abd1806-4841.20188396 https://doi.org/10.1590/abd1806-4841.201... (2018), Brazil	N/I	Homemade	N/I	N/I
Tehrany et al.²⁰20. Tehrany YA, Quenan S, Bugey A, Piletta P. Contact dermatitis caused by homemade “slime”: report of two cases with chemical analysis. Contact Dermatitis. 2019;80:407-8. https://doi.org/10.1111/cod.13230 https://doi.org/10.1111/cod.13230... (2019), Switzerland	Liquid laundry detergent, special glue, contact lens solution, home fragrance, and shaving foam	Homemade	MCI/MI, slime	Patch test
	Liquid detergent, shaving foam, special glue, and glitters	Homemade	MCI/MI, liquid detergent	Patch test
Anderson et al.²¹21. Anderson LE, Treat JR, Brod BA, Yu J. “Slime” contact dermatitis: case report and review of relevant allergens. Pediatr Dermatol. 2019;36:335-7. https://doi.org/10.1111/pde.13792 https://doi.org/10.1111/pde.13792... (2019), USA	Laundry detergent, liquid dish soap, shampoo, and hand cream	Homemade	MCI/MI	Patch test
Salman et al.²²22. Salman A, Demir G, Apti O. “Slime”: a trending cause of isothiazolinone contact allergy in children. Contact Dermatitis. 2019;80:409-11. https://doi.org/10.1111/cod.13237 https://doi.org/10.1111/cod.13237... (2019), Turkey	Dishwashing liquid (main allergenic ingredient)	Homemade	MCI/MI	Patch test
	Polyvinyl acetate glue (main allergenic ingredient)	Homemade	MCI/MI	Patch test
	Liquid soap (main allergenic ingredient)	Homemade	MCI/MI	Patch test
Mainwaring et al.²³23. Mainwaring W, Zhao J, Hunt R. Allergic contact dermatitis related to homemade slime: a case and review of the literature. Dermatol Online J. 2019;25:13030/qt7n06w0hg. PMID: 31046914 (2019), USA	White glue, glitter, shaving cream, artificial food color, and borax	Homemade	MCI/MI, Quaternium-15	Patch test
Kong et al.²⁴24. Kong C, Lam JM. Slime dermatitis. CMAJ. 2019;191:E536. https://doi.org/10.1503/cmaj.181511 https://doi.org/10.1503/cmaj.181511... (2019), Canada	Sodium borate (main allergenic ingredient)	Homemade	N/I	N/I
Pessotti et al.²⁵25. Pessotti NS, Hafner MF, Possa MS, Lazzarini R. Allergic contact dermatitis to slime. An Bras Dermatol. 2020;95:265-6. https://doi.org/10.1016/j.abd.2019.06.008 https://doi.org/10.1016/j.abd.2019.06.00... (2020), Brazil	Body moisturizer, boricated water, glue, baking soda, blue food dye, and shaving foam	Homemade and manufactured	MCI/MI	Patch test
Córdoba et al.²⁶26. Córdoba S, Blanco-Calvo M, Huerta-Vena A, Borbujo J. Allergic contact dermatitis due to slime. Actas Dermosifiliogr (Engl Ed). 2021;112:285-7. https://doi.org/10.1016/j.ad.2020.03.006 https://doi.org/10.1016/j.ad.2020.03.006... (2021), Spain	Liquid detergent (main allergenic ingredient)	Homemade	MCI/MI	Patch test
Saad et al.²⁷27. Saad S, Lahouel I, Belhadjali H, Kheder A, Youssef M, Zili J. “Hand-borne” allergic contact dermatitis of the face to slime, possibly photoaggravated. Contact Dermatitis. 2020;82:329-30. https://doi.org/10.1111/cod.13475 https://doi.org/10.1111/cod.13475... (2020), Tunisia	Laundry detergent, glue, and food coloring.	Homemade	MCI/MI	Patch test
Brazen et al.²⁸28. Brazen BC, Wehausen B, Usmani AA. Not all fun and games: a case report of contact dermatitis related to slime and play-doh. Cureus. 2020;12:e10272. https://doi.org/10.7759/cureus.10272 https://doi.org/10.7759/cureus.10272... (2020), USA	N/I	N/I	N/I	Not tested

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[1] *Corresponding author. E-mail: eric.barioni@prof.uniso.br (É. D. Barioni).