Airborne pigmented contact dermatitis due to musk ambrette in incense

We reported 2 patients with pigmented contact dermatitis caused by occupational airborne contactants, whitening dyes in clothes and formaldehyde in packing adhesive tapes. A woman developed airborne pigmented contact dermatitis due to musk ambrette in incense. Patch testing confirmed the diagnosis. Since olden times, people in Japan have burnt incense when they worshipped their ancestors. Recently, it has been in fashion to enjoy perfumes and people may burn incense all day long every day. Our patient burnt 2 kinds of incense every day for about 5 years. We assumed musk ambrette was volatilized when incense was burnt, and contact on her face being dissolved in sebum, thus inducing allergic pigmented contact dermatitis.