Allergic contact dermatitis and diabetes medical devices: 2 clinical cases

Passanisi, Stefano; Lombardo, Fortunato; Barbalace, Andrea; Caminiti, Lucia; Panasiti, Ilenia; Crisafulli, Giuseppe; Salzano, Giuseppina; Pajno, Giovanni Battista

doi:10.1111/cod.13012

Cited by 42 publications

(37 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In recent years, cases of ACD resulting from the use of medical devices in patients with diabetes have been increasingly reported in the literature. Passanisi et al described ACD from the glucose sensor Enlite caused by colophonium, the presence of which was confirmed by the manufacturer. In our patients, only case 4 presented a positive reaction to colophonium and glyceryl rosinate (−/+), the latter being a colophonium derivative.…”

Section: Discussionmentioning

confidence: 92%

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

et al. 2019

View full text Add to dashboard Cite

Background: The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens.Objectives: To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set. Patients and Methods: Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed.Results: Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set.Conclusions: IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.acrylates, allergic contact dermatitis, delayed hypersensitivity, glucose sensor, insulin pump, isobornyl acrylate, medical device

show abstract

Section: Discussionmentioning

confidence: 92%

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

et al. 2019

View full text Add to dashboard Cite

show abstract

“…7085‐85‐0), which is a common constituent of instant glues . Enlite has been reported to contain colophonium (rosin) . Later, Dexcom developed new sensors, G5 and G6, without ethyl cyanoacrylate .…”

Section: Introductionmentioning

confidence: 99%

“…3 Enlite has been reported to contain colophonium (rosin). 4 Later, Dexcom developed new sensors, G5 and G6, without ethyl cyanoacrylate. 5 According to the Dexcom website, the new sensors contain a pressure-sensitive acrylic adhesive coated on top of a polyester spun lace fabric.…”

Section: Introductionmentioning

confidence: 99%

Allergic contact dermatitis caused by glucose sensors in type 1 diabetes patients

2019

View full text Add to dashboard Cite

Background: Allergic contact dermatitis caused by glucose sensors has become an increasing problem. Contact allergies to isobornyl acrylate, colophonium, ethyl cyanoacrylate and N,N-dimethylacrylamide have been reported. However, there is a paucity of information regarding the prevalence of sensor-related dermatitis and detailed patient histories.Objectives: To evaluate diabetes patients who have developed allergic contact dermatitis caused by glucose sensors.Patients and methods: Seventy patients with suspected contact allergy to glucose sensors referred to university hospital dermatology clinics in southern Finland were patch tested with the baseline series, an isobornyl acrylate dilution series, and a number of other acrylates. Atopic constitution, contact allergies, the severity of the dermatitis and the ability to continue with the same or another type of sensor were recorded.Results: Positive patch test reactions to isobornyl acrylate were seen in 51 of 63 (81%) Freestyle Libre users. Colophonium or its derivatives gave positive reactions in five of seven Medtronic Enlite users. The median duration of sensor use before dermatitis was 6 months. The estimated prevalences of contact allergy to sensor adhesives were 0.7% for Freestyle Libre and 0.8% for Enlite. Conclusions:We suggest that patients who have difficulties in finding a tolerable glucose sensor or an insulin pump should be patch tested.acrylates, adhesives, allergic contact dermatitis, CAS no. 5888-33-5, glucose sensors, isobornyl acrylate, medical device, type 1 diabetes

show abstract

“…Note that Patient 12 presented a positive reaction to colophonium. Passanisi et al described ACD from the glucose sensor Enlite caused by colophonium, the presence of which was confirmed by the manufacturer. Moreover, gas chromatography–mass spectrometry (GC–MS) analysis revealed the presence of methyldehydroabietate, which indicates the use of colophonium in this device .…”

Section: Discussionmentioning

confidence: 92%

Contact dermatitis caused by glucose sensors in diabetic children

et al. 2019

View full text Add to dashboard Cite

Background Allergic contact dermatitis caused by glucose sensors has been recently described in diabetics, mostly in adult patients. Isobornyl acrylate and N‐N dimethylacrylamide are the potent causative agents. Objectives To describe a child population with contact dermatitis caused by glucose sensors, determine the causative allergen, and assess the prevalence of isobornyl acrylate (IBOA) sensitization. Patients and Methods Overall, 12 children with a reaction to medical devices, either glucose sensors or insulin sets, were patch tested with the European baseline series, glues and rubber, (meth) acrylates series, and with piece of the adhesive part of the glucose sensor FreeStyle Libre. Isobornyl acrylate 0.1% pet. was patch tested in 11 patients, and N‐N dimethylacrylamide in two. Some patients were tested with adhesive parts of the infusion set. Results Overall, 10 children reacted to the adhesive part of the sensor FreeStyle Libre, and 10 children were sensitized to IBOA. One patient turned out to be negative in all patch tests. Conclusion Allergic contact dermatitis caused by glucose sensors is common in the pediatric diabetic patient population. Like in the adult patient population, IBOA was the culprit allergen, with 83.3% sensitization prevalence in children exhibiting adverse cutaneous reactions caused by FreeStyle Libre.

show abstract

Allergic contact dermatitis and diabetes medical devices: 2 clinical cases

Cited by 42 publications

References 11 publications

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

Allergic contact dermatitis caused by glucose sensors in type 1 diabetes patients

Contact dermatitis caused by glucose sensors in diabetic children

Contact Info

Product

Resources

About