Contact dermatitis in children caused by diabetes devices

Abstract

Background: Insulin pumps and glucose monitoring devices improve diabetes mellitus control and enhance patients' quality of life. However, a growing number of adverse cutaneous reactions related to the use of these devices have been reported.Objective: To investigate the culprits of localized contact dermatitis in paediatric patients with diabetes caused by insulin pumps and glucose monitoring devices.Methods: Retrospective analysis of 15 paediatric patients patch tested as part of a clinical investigation for skin reactions associated with insulin pumps and glucose monitoring devices.Results: Seven patients had positive patch test reactions to isobornyl acrylate (IBOA) and five had positive reactions to benzoyl peroxide (BP). Positive patch test reactions to materials from the glucose sensor and/or insulin pump were seen in 10 of the 15 patients. Three had positive reactions to adhesive remover wipe from Smith and Nephew Remove and four had reactions to EMLA plaster. Conclusion:A high share of patients showed positive reactions to IBOA and/or their medical devices (insulin pumps or glucose devices). A third of patients showed positive reactions to BP. The presence of additional unidentified allergens cannot be excluded, highlighting the importance of access to a full description of the chemical composition of the devices.

Allergic contact dermatitis elicited by insulin infusion sets: First case reported in Poland

“…There are no official reports about allergic reactions from diabetes devices in Poland. However, an increasing number of such cases are currently reported, especially in paediatric patients 2 . Interestingly, our patient appears to be primarily sensitized from the use of IBOA‐containing insulin infusion sets, with additional ACD developing from his glucose sensor 1 year later, the culprit allergen(s) in the latter currently being unknown (new introduction of IBOA in this device, or ACD from other skin sensitizers present in this sensor?…”

A toddler with systemic contact dermatitis caused by diabetes devices

“…The acrylic monomer IBOA is found in paints, ink, plastics, and rubber products, non‐pesticidal agricultural products like herbs and plants, as well as in adhesives and sealants 5,13 . IBOA causing allergic contact dermatitis in diabetes patients is now widely known 2 . PTBC has, to our knowledge, not been described as a contributor to allergic contact dermatitis related to diabetes devices.…”

“…In Norway, the vast majority of T1D patients below the age of 18 are using both devices 1 . Use of hapten‐containing diabetes devices and adhesives can, however, trigger allergic contact dermatitis 2 . Colophonium, N,N‐dimethylacrylamide, ethyl cyanoacrylate, abitol and isobornyl acrylate (IBOA) are all documented in allergic contact dermatitis from diabetes devices, with IBOA being the most frequently reported 3,4 .…”

“…Colophonium, N,N‐dimethylacrylamide, ethyl cyanoacrylate, abitol and isobornyl acrylate (IBOA) are all documented in allergic contact dermatitis from diabetes devices, with IBOA being the most frequently reported 3,4 . Allergic contact dermatitis in patients dependent on glucose monitors and insulin pumps is an issue of growing concern, and IBOA was named ‘Allergen of the Year’ in 2020 by The American Contact Dermatitis Society 2,5,6 . We describe a toddler who developed systemic contact dermatitis to IBOA and 4‐tert‐butylcatechol (PTBC) found in her diabetes devices.…”

“…1 Use of hapten‐containing diabetes devices and adhesives can, however, trigger allergic contact dermatitis. 2 Colophonium, N,N‐dimethylacrylamide, ethyl cyanoacrylate, abitol and isobornyl acrylate (IBOA) are all documented in allergic contact dermatitis from diabetes devices, with IBOA being the most frequently reported. 3 , 4 Allergic contact dermatitis in patients dependent on glucose monitors and insulin pumps is an issue of growing concern, and IBOA was named ‘Allergen of the Year’ in 2020 by The American Contact Dermatitis Society.…”