Brief Answer:
possible, but need more details

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your mother's history and would like to make suggestions for her as follows:

1. First of all, I would like to know more about how your mother's allergy to chlorocresol was diagnosed.

a. Whether it was confirmed with particular testing.
b. What medications tried and how was the response.
c. Since what age she is allergic to chlorocresol.
d. Since what age she is using levemir. (Levemir is a insulin used for diabetes. In question, you have mentioned levimir. Kindly let me know what it is).
e. What are her allergy symptoms and how she responds to betnesol and other drugs.
f. Does she have any other allergies?
g. Does she have any other medical conditions?
h. Does she take any other medications on frequent/regular basis?

Above details would help me to know about problem better and therefore to make suggestions for her more specifically.

2. At present, I can say is that Chlorocresol (p-Chloro-m-Cresol) can be immunologically related to metacresol (m-Cresol). So they might be cross-reacting with each other.

3. However, there are other constituents in any drug formulation and cosmetics that can be allergic or irritant for the skin. So it is difficult to definitely conclude that it's m-cresol in Levemir that is causing allergies to her.

4. Moreover, Levemir is an insulin, very important for diabetes control. So it's very important to discuss possibility of allergic reaction to one of the constituents of insulin product with your mother's physician before making changes in insulin regimen. (kindly confirm on follow-up that what Levimir is)

Hope above information will be helpful to you.

Should you have any further query, please feel free to ask on follow-up.

Wish your mother the best of the health ahead.

Thank you & Regards,

Dr Parin N Parmar

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Brief Answer:
Please discuss the options in detail with your mother's doctor

Detailed Answer:
Hello,

Thank you for your follow up.

I went through all her details and would suggest her as follows:

1. I can understand the problem of itching.

Please make sure that she does not scratch the itchy areas as scratching would worsen the itching. If she has urge to itch, I usually suggest my patients to gently "touch" the itchy areas without scratching, which sometimes help.

2. She is already taking hydroxyzine which reduces itching. I assume she is taking prednisolone for itching/dermatitis? I just want to mention that prednisolone can worsen diabetes and hypertension as side effect. Please discuss this matter with her physician.

3. Dry skin can worsen itching. So I usually suggest my patients to use moisturizing cream (which do not contain m-cresol or chlorocresol, for your mother) especially immediately after bathing to retain moisture and improve dryness of the skin.

4. Decision of changing/withholding levemir for m-cresol content needs a lot of discussion with your doctor.

As allergy to chlorocresol is found on patch testing, it is reliable.

Scientifically, there is possibility that chlorocresol and m-cresol (in levemir) could be cross-reacting with each other. Such a few cases have been reported in medical literature in past.

On other hand, there is possibility of altered control of diabetes as well, which is also very important. Also, as she is taking gliclazide also, it is important to know whether other safe options are available to maintain control of diabetes.

I would suggest you to discuss these possibilities with both your mother and her doctor. Then only further steps could be taken.

Hope above suggestions and information will be helpful to you.

Should you have any further query, please feel free to ask at HCM.

Wish your mother the best of the health ahead.

Thank you & Regards

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