Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

Abstract

Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD) in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports' material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

Allergic contact dermatitis from diethylthiourea and carbamates in neoprene prayer socks with severe flare‐up during patch testing

“…Neoprene footwear–induced ACD is reported especially from sandals, shoes, and boots; diving suits; or insoles . Thin neoprene socks such as thermal prayer socks in our patient have hitherto not been reported as a cause of ACD.…”

“…Neoprene footwear-induced ACD is reported especially from sandals, shoes, and boots; diving suits; or insoles. [1][2][3]10 Thin neoprene socks such as thermal prayer socks in our patient have hitherto not been reported as a cause of ACD. Thermal prayer socks are wellknown in Muslim countries like Turkey for the purpose of ablution, a ritual washing before prayer.…”

“…thermal Thioureas are well known causes of allergic contact dermatitis (ACD) from neoprene footwear. [1][2][3] We report a case with severe foot eczema caused by diethylthiourea and carbamates in a novel footwear product, neoprene prayer socks, showing a severe flare-up during patch testing.…”

Isothiocyanates are important as haptens in contact allergy to chloroprene rubber

“…The extended use of chloroprene rubber (Neoprene ® ) in commercial products has resulted in an increased number of reported cases of allergic contact dermatitis (ACD), attributed to organic thiourea traces being left in the rubber after the manufacturing process. The role of organic thioureas in the production of chloroprene polymer materials is to work as accelerators and antioxidants . The synthetic rubber is produced by polymerization of 2‐chloro‐1,3‐butadiene monomers, introduced in 1930 by E.I.…”

“…The role of organic thioureas in the production of chloroprene polymer materials is to work as accelerators and antioxidants. [1][2][3][4][5][6] The synthetic rubber is produced by polymerization of 2chloro-1,3-butadiene monomers, introduced in 1930 by E.I. DuPont de Nemours & Co. in Wilmington, DE, U.S.A., as a substitute for natural rubber.…”