Allergic contact dermatitis caused by isobornyl acrylate in Freestyle® Libre, a newly introduced glucose sensor

Abstract

Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.

Alkyl glucosides: Newly identified allergens in foam wound dressings

“…Despite the suggestion that IBOA, an allergen that has recently shown to be present in medical devices for diabetic patients, might also be an impurity and allergen in products containing alkyl glucosides, we could not show the presence of this acrylate in the glucoside‐containing foam dressings, or in the glucoside‐containing pet.‐based patch test materials. This makes it rather unlikely that IBOA plays a role in contact‐allergic reactions resulting from the use of these glucoside‐containing wound dressings, and nor does it seem to explain allergic reactions to glucoside patch test materials.…”

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

“…No allergic reactions were seen during the study period. Recently, however, several cases of severe allergic contact dermatitis caused by isobornyl acrylate have been reported after prolonged use of the FGM [49]. All patients and caregivers should be warned about this possible complication.…”

Isobornyl acrylate contained in the insulin patch pump OmniPod as the cause of severe allergic contact dermatitis

“…Our finding supports observations of the Belgian group, which identified IBOA in the glucose sensor itself . Furthermore, our findings are very well in line with patient reports indicating that the strongest skin symptoms occur directly in the area where the plastic boxes of the sensor and the pump contact the skin.…”

“…Subsequently, we used IBOA 0.1% pet. kindly provided by the authors who were the first to identify IBOA as a relevant contact allergen in glucose monitoring systems . IBOA elicited a strong (++) reaction on D3.…”

“…However, some patients have experienced contact dermatitis at the sites where glucose monitoring systems or patch insulin pumps had been fixed. As 1 substance causing allergic contact dermatitis (ACD), isobornyl acrylate (IBOA) was identified in a series of patients from Belgium and Sweden …”