rosin and isobornyl-acrylate

The number of patients with contact dermatitis from glucose sensors and insulin infusion sets is increasing. Patch testing is challenging because of a lack of information concerning the constituent materials of medical devices.. To report on products and causes of allergic reactions to glucose sensors or insulin infusion sets over a 5-year period and suggest a short screening series.. Analysis of patch test data from consecutive patients suspected of allergic contact dermatitis (ACD) to glucose sensors and/or insulin infusion sets from 2015-2019.. Patient numbers increased from 4 to 15 per year; 30/38 (78.9%) were children. In 29 (76.3%), a diagnosis of allergic/probable ACD was established, mostly due to the tapes of the device or allergens in these tapes (n = 23) followed by allergens in the device housing (n = 10). Isobornyl acrylate, abitol, and colophonium were the most common allergens. Information from manufacturers was often difficult to obtain and, if accessible, inadequate. For this reason, the diagnosis was delayed for more than 1.5 years in 12 (31%) patients.. The increasing number of patients, mostly children, with ACD from devices used in treatment of type 1 diabetes demonstrates the importance of this problem. Allergies can easily be overlooked, due to the lack of mandatory labeling of the constituent materials of the devices.

Topics: Abietanes; Acrylates; Adolescent; Adult; Allergens; Blood Glucose Self-Monitoring; Camphanes; Child; Child, Preschool; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Humans; Insulin Infusion Systems; Male; Middle Aged; Patch Tests; Resins, Plant; Retrospective Studies; Surgical Tape; Young Adult

Topics: Acrylates; Adhesives; Adult; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Female; Humans; Insulin Infusion Systems; Patch Tests; Resins, Plant

Allergic contact dermatitis caused by glucose sensors has become an increasing problem. Contact allergies to isobornyl acrylate, colophonium, ethyl cyanoacrylate and N,N-dimethylacrylamide have been reported. However, there is a paucity of information regarding the prevalence of sensor-related dermatitis and detailed patient histories.. To evaluate diabetes patients who have developed allergic contact dermatitis caused by glucose sensors.. Seventy patients with suspected contact allergy to glucose sensors referred to university hospital dermatology clinics in southern Finland were patch tested with the baseline series, an isobornyl acrylate dilution series, and a number of other acrylates. Atopic constitution, contact allergies, the severity of the dermatitis and the ability to continue with the same or another type of sensor were recorded.. Positive patch test reactions to isobornyl acrylate were seen in 51 of 63 (81%) Freestyle Libre users. Colophonium or its derivatives gave positive reactions in five of seven Medtronic Enlite users. The median duration of sensor use before dermatitis was 6 months. The estimated prevalences of contact allergy to sensor adhesives were 0.7% for Freestyle Libre and 0.8% for Enlite.. We suggest that patients who have difficulties in finding a tolerable glucose sensor or an insulin pump should be patch tested.

Topics: Acrylates; Adolescent; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Child; Child, Preschool; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Disposable Equipment; Female; Humans; Male; Middle Aged; Patch Tests; Resins, Plant; Young Adult

The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens.. To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set.. Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed.. Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set.. IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.

Topics: Acrylates; Adhesives; Adolescent; Adult; Blood Glucose Self-Monitoring; Camphanes; Child, Preschool; Dermatitis, Allergic Contact; Female; Home Infusion Therapy; Humans; Infusion Pumps; Male; Middle Aged; Patch Tests; Resins, Plant