Allergic contact dermatitis resulting from a poly(carbonate urethane) chronic haemodialysis central venous catheter

Allergic contact dermatitis caused by a polyurethane catheter

“…More recently, in a workshop handling polyurethane foams, 6 of 8 workers showed positive patch test reactions to MDA . To our knowledge, only 2 cases of contact dermatitis caused by a similar polyurethane central catheter have been published so far, and the causative allergens were not identified . Even though MDA was not listed in the composition of the PICC, clinical relevance was confirmed by positive reactions to the catheter and by subsequent clearance of the dermatitis through avoidance of exposure.…”

“…2 To our knowledge, only 2 cases of contact dermatitis caused by a similar polyurethane central catheter have been published so far, and the causative allergens were not identified. 3,4 Even though MDA was not listed in the composition of the PICC, clinical relevance was confirmed by positive reactions to the catheter and by subsequent clearance of the dermatitis through avoidance of exposure. MDA was confirmed to be a marker for isocyanate sensitivity, and, in cases of skin problems caused by polyurethane catheters, silicone materials can be considered to constitute a good alternative.…”

Hypersensitivity reactions in patients receiving hemodialysis

“…These patients developed widespread dermatitis of the trunk within a few weeks of catheter placement. 35,36 Patch tests were carried out with different components of similar catheters and in the 2 cases a positive patch test reaction was noted and persisted for 108 hours. Polyurethanes are derived from isocyanates, which are strong sensitizers, and probably, for that reason, such haptens induce a contact allergy a few weeks after catheter insertion with a longlasting positivity to patch tests.…”

“…Polyurethanes are derived from isocyanates, which are strong sensitizers, and probably, for that reason, such haptens induce a contact allergy a few weeks after catheter insertion with a longlasting positivity to patch tests. 35 However, patients reporting an ACD induced by polyurethane often show a negative patch test reaction to isocyanates, which could be due to differences in the composition and concentration of the antigen in commercially available patch test preparations. 35 One of the described patients also exhibited a positive patch test reaction to 1% beryllium chloride in petrolatum, but the investigators did not investigate or speculate about the possibility of a clinically relevant hypersensitivity to that metal in the patient.…”

“…35 However, patients reporting an ACD induced by polyurethane often show a negative patch test reaction to isocyanates, which could be due to differences in the composition and concentration of the antigen in commercially available patch test preparations. 35 One of the described patients also exhibited a positive patch test reaction to 1% beryllium chloride in petrolatum, but the investigators did not investigate or speculate about the possibility of a clinically relevant hypersensitivity to that metal in the patient. 35 Metals should be considered another potential cause of contact allergy in patients on dialysis; only a single case of nickel dermatitis has been reported, 37 although contact dermatitis from nickel released by needles or infusion pumps has been described in the literature.…”