Contact Dermatitis From Gum Mastic (Pistacia lentiscus) and Gum Storax (Liquidambar styraciflua) in Mastisol-Allergic Patients

Abstract

Background: Mastisol Liquid Adhesive is widely used on the skin, especially after surgical procedures. It contains gum mastic, gum storax, methyl salicylate, and ethanol.Objective: The aims of the study were to review our experience patch testing patients allergic to Mastisol and to assess coreacting substances.Methods: We identified 18 patients who were allergic to Mastisol. Most of these had a history of postoperative or cardiac electrode dermatitis and underwent patch testing with multiple surgically related substances, including ingredients of Mastisol, compound tincture of benzoin, and fragrance-related ingredients and botanicals.Results and Conclusions: Among Mastisol-allergic patients, 13 (72%) of 18 were allergic to gum mastic, whereas 7 (44%) of 16 were allergic to gum storax. There was frequent coreactivity with various fragrance-related materials, including Majantol, Styrax benzoin, Myroxylon balsamum, Myroxylon pereirae, propolis, and others. Two gum mastic-allergic patients had positive patch tests with hydroperoxides of linalool and several other linalool-containing essential oils. As gum mastic contains linalool, it may explain some gum mastic reactions. Among patients without a history of postoperative contact dermatitis, 1 (0.4%) of 250 was patch test positive for gum mastic. This patient had allergic contact dermatitis from fragrances, so the gum mastic reaction was likely a true-positive relevant reaction.

Incidence and Predictive Model of Medical Adhesive–Related Skin Injury in Cancer Patients Managed With Central Venous Access Devices

“…We further hypothesize that elements in various types of medical adhesives may have led to MARSI such as latex particles that may create a hypersensitivity response manifested as irritant contact dermatitis and formation of blisters. 3,[15][16][17] Nutritional status of patients has been postulated to influence the risk for MARSI and we found that patients who developed MARSI were more likely to require TPN for nutritional support. 18,19 In addition to these factors, the choice of medical adhesive device, duration of its use, and techniques for applying and removing tapes influence the likelihood of MARSI.…”

“…We also found that a higher proportion of patients who developed MARSI had a history and positive skin scratch tests (8.9% vs 3.0%). We further hypothesize that elements in various types of medical adhesives may have led to MARSI such as latex particles that may create a hypersensitivity response manifested as irritant contact dermatitis and formation of blisters 3,15–17. Nutritional status of patients has been postulated to influence the risk for MARSI and we found that patients who developed MARSI were more likely to require TPN for nutritional support 18,19.…”

Overview of Chios Mastic Gum (Pistacia lentiscus) Effects on Human Health

“…Mastic gum consumption is generally considered safe, although the long-term safety has not been sufficiently investigated, and the maximum safe dose remains still unknown. Beyond some cases of allergic contact dermatitis following postoperative use of patches containing mastic, there are hardly any reports of remarkable side effects [56]. High doses of mastic have also been well tolerated in clinical trials, and no adverse effects have been recorded.…”