isobornyl-acrylate and Dermatitis--Allergic-Contact

This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates.. Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.

Topics: Acrylates; Acyclic Monoterpenes; Allergens; Allergy and Immunology; Camphanes; COVID-19; Dermatitis, Allergic Contact; Dermatitis, Occupational; Dermatology; Health Personnel; Humans; Lavandula; Limonene; Pandemics; Patch Tests; Propylene Glycol; Societies, Medical; United States

Topics: Acrylates; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Humans; Insulins; Patch Tests

Topics: Acrylates; Allergens; Camphanes; Dermatitis, Allergic Contact; Dermatitis, Contact; Glucose; Humans; Hypersensitivity; Patch Tests

Topics: Acrylates; Blood Glucose Self-Monitoring; Camphanes; Cross Reactions; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Humans; Lactones; Male; Molecular Structure; Patch Tests; Sesquiterpenes; Young Adult

Topics: Acrylates; Adhesives; Antibodies, Monoclonal, Humanized; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 2; Humans; Insulin Infusion Systems; Patch Tests

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.. To investigate the culprits of localized contact dermatitis in paediatric patients with diabetes caused by insulin pumps and glucose monitoring devices.. 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.. 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.. 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.

Topics: Acrylates; Adhesives; Allergens; Benzoyl Peroxide; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Humans; Insulins; Patch Tests; Quality of Life; Retrospective Studies

Isobornyl acrylate (IBOA) has recently caused a number of cases of allergic contact dermatitis (ACD) from its use in medical devices. We would like to enhance the awareness of this issue with the reporting of three Australian cases, involving two adults and a child. We also report a successful solution by using hydrocolloid wafer (Stomahesive®) as a barrier. As IBOA is not usually found on baseline patch test series and does not cross-react with other acrylic monomers, ACD to IBOA may be missed by clinicians.

Topics: Acrylates; Bandages, Hydrocolloid; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Female; Humans; Male; Middle Aged; Patch Tests

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

Concomitant positive patch test reactions in patients sensitized to isobornyl acrylate (IBOA) have rarely been documented.. To report concomitant sensitizations in patients with allergic contact dermatitis (ACD) from the glucose sensor FreeStyle Libre and sensitized to IBOA.. In 2019, 26 patients with suspected ACD from FreeStyle Libre were patch tested to a baseline series and to a (meth) acrylate series containing IBOA and 2-phenoxyethyl acrylate (PEA) 0.1% pet. Diabetes devices and patch test preparations were analyzed with gas chromatography - mass spectrometry (GC-MS) for the presence of IBOA and PEA.. Of the 26 patients, 18 (69%) were sensitized to IBOA, and eight (44%) and 11 (61%) of these were co-sensitized to sesquiterpene lactones and fragrances, respectively. Ten patients (56%) were co-sensitized to PEA, which, contrary to IBOA, could not be detected in any device. The PEA test material was shown to be contaminated with IBOA.. Contact allergy to IBOA appears to be declining and IBOA-sensitized patients are most often co-sensitized to sesquiterpene lactones and fragrances. Vigilance is required when patch testing (acrylate) materials obtained from industry, as these might be contaminated and, hence, alter the results and their interpretation.

Topics: Acrylates; Adolescent; Adult; Aged; Allergens; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Female; Humans; Insulin Infusion Systems; Male; Middle Aged; Odorants; Patch Tests; Sesquiterpenes; Young Adult

Topics: Acrylates; Adult; Camphanes; Cell Phone; Dermatitis, Allergic Contact; Dermatitis, Occupational; Female; Hand Dermatoses; Humans; Patch Tests

Topics: Acrylates; Adolescent; Blood Pressure Monitoring, Ambulatory; Camphanes; Dermatitis, Allergic Contact; Disposable Equipment; Humans; Male; Patch Tests

Medical devices (MD) in close skin-contact for a prolonged time, such as glucose monitoring (CGM) systems, are a risk factor for contact allergy, and there has been an increase in patients using these. Correct diagnosis demands targetted testing.. We report a new allergen in a continuous CGM system in which the adhesive was changed. The allergy pattern of the patients diagnosed is reported.. The three patients reported were patch tested with an MD series, own material, and possible allergens found through analysis with gas chromatography-mass spectrometry, comparing analysis from the CGM system before and after change.. The patients were sensitized to isobornyl acrylate (IBOA), found in previously used devices and the present CGM. Apart from IBOA, the culprit allergen was found to be 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate.. Allergic contact dermatitis due to CGM systems and insulin pumps are difficult to investigate and require chemical analysis. Because of the lack of information on substances used in the production, and when changes with MDs are initiated, it is difficult to advise patients, especially since they risk sensitization to several allergens. The use of MDs has increased and, thus, the need for collaboration between manufacturers, clinicians, and patient organizations.

Topics: Acrylates; Adhesives; Adult; Blood Glucose Self-Monitoring; Butylated Hydroxytoluene; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Patch Tests

Topics: Acrylates; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Humans

Topics: Acrylates; Allergens; Belgium; Camphanes; Dermatitis, Allergic Contact; Dermatitis, Occupational; Female; Humans; Male; Medical Staff, Hospital; Patch Tests

Allergic contact dermatitis from glucose sensors may interfere with their ongoing application.. To evaluate a series of Spanish patients with contact dermatitis to glucose sensors regarding former sources of contact allergens, patch test results, and outcomes from the ongoing use of the device.. A series of patients with contact dermatitis from glucose sensors was investigated in eight dermatology departments across Spain (epidemiological features, brands, latency time to develop dermatitis, the ability to continue using the devices as well as the patch test results).. Thirty patients were evaluated (mean age 20.9 years). A total of 66.7% were children and 66.7% female. Ninety per cent used Freestyle Libre (FSL). Eight of 26 (30.8%) reacted to isobornyl acrylate (IBOA) and two of 20 (10.0%) to N,N dimethylacrylamide (DMAA). The mean latency time to develop dermatitis was 9 months. Sixteen of 29 (55.2%) patients continued using the same sensor causing the reaction. Thirteen of 29 (44.8%) patients were unable to continue using the sensor because of severe reactions. Of these, five were positive to IBOA, one to IBOA and DMAA, one to DMAA, one to colophony, and one to isopropyl alcohol wipes. In one patient, the outcome was unknown.. The frequency of sensitisation to IBOA and DMAA, was lower than in other European series, but similar to a previously published Spanish article. Legislation requiring manufacturers to provide information regarding the composition of medical devices and cooperate with the investigations into contact dermatitis is urgently needed.

Topics: Acrylates; Adult; Allergens; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Humans; Insulin Infusion Systems; Male; Patch Tests; Spain; Young Adult

Some patients with diabetes develop skin reactions when using systems for continuous glucose monitoring (CGM) or insulin pumps. Regular usage and long wearing periods lead not only to skin irritation, but also to allergic contact dermatitis. It has been shown that allergens such as isobornyl acrylate (IBOA) are present in the plastic housing and also in the adhesives of medical devices used for diabetes treatment.. To evaluate the IBOA content of all parts of a newly introduced, implanted CGM system (Eversense) to check whether this can be an alternative for IBOA-sensitized patients.. The IBOA content of the implanted sensor itself (n = 3), the transmitter (n = 3), and two different types of adhesive (white adhesive [n = 4] and clear adhesive [n = 4]) was measured by gas chromatography/mass spectrometry.. No IBOA was found in any part of this CGM system.. Patients with an IBOA allergy may be able to use this implanted CGM system.

Topics: Acrylates; Adhesives; Allergens; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Disease Management; Equipment and Supplies; Female; Humans; Insulin Infusion Systems; Male

Continuous glucose monitoring (CGM) systems replace more and more capillary self-monitoring of blood glucose by patients with diabetes. However, at least a subset of patients experience adverse skin reactions such as severe allergic contact dermatitis (ACD) after prolonged usage of CGM systems. A major allergen isobornyl acrylate (IBOA) has been identified recently.. After developing an ACD, patients have difficulties in continuing the usage of their CGM system (and also of, eg, certain patch pumps). Most of such patients look for possibilities to continue the usage of, eg, a CGM system that requires intermittent scanning (iscCGM, Freestyle Libre).. Eight patients with a known ACD were supplied with different hydrocolloid-based plasters (. All patients were able to continue the usage of this iscCGM system when using such plasters.. Patients with ACD benefit from the usage of such plasters; however, some limitations have to be acknowledged.

Topics: Acrylates; Adult; Bandages, Hydrocolloid; Biomarkers; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Equipment Design; Female; Humans; Male; Middle Aged; Patch Tests; Predictive Value of Tests; Risk Assessment; Risk Factors; Treatment Outcome

Allergic contact dermatitis caused by glucose sensors has been recently described in diabetics, mostly in adult patients. Isobornyl acrylate and N-N dimethylacrylamide are the potent causative agents.. To describe a child population with contact dermatitis caused by glucose sensors, determine the causative allergen, and assess the prevalence of isobornyl acrylate (IBOA) sensitization.. Overall, 12 children with a reaction to medical devices, either glucose sensors or insulin sets, were patch tested with the European baseline series, glues and rubber, (meth) acrylates series, and with piece of the adhesive part of the glucose sensor FreeStyle Libre. Isobornyl acrylate 0.1% pet. was patch tested in 11 patients, and N-N dimethylacrylamide in two. Some patients were tested with adhesive parts of the infusion set.. Overall, 10 children reacted to the adhesive part of the sensor FreeStyle Libre, and 10 children were sensitized to IBOA. One patient turned out to be negative in all patch tests.. Allergic contact dermatitis caused by glucose sensors is common in the pediatric diabetic patient population. Like in the adult patient population, IBOA was the culprit allergen, with 83.3% sensitization prevalence in children exhibiting adverse cutaneous reactions caused by FreeStyle Libre.

Topics: Acrylates; Adhesives; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Humans; Male

Topics: Acrylates; Aged; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Female; Humans; Patch Tests

Cutaneous adverse events (CAE) from FreeStyle Libre include allergic contact dermatitis (ACD) caused by the allergen isobornyl acrylate (IBOA). We aim to report CAE from this glucose sensor, ACD to IBOA in particular, and the outcome of using barrier films as a prevention.. A monocentric, retrospective review of medical files from adult and pediatric patients with diabetes using Freestyle Libre, in the period between December 2016 and April 2019, was performed with a focus on CAE.. Fifty-seven of 1,036 patients with diabetes (5.5%) were referred to our dermatology department because of CAE from FreeStyle Libre. Thirty-nine of 1,036 (3.8%) had ACD due to IBOA. Only two patients, of whom one sensitized to IBOA, had a benefit from using barrier films.. CAE occurred in 5.5% of FreeStyle Libre users, and 3.8% suffered from ACD due to IBOA. Barrier films had limited value in the prevention.

Topics: Acrylates; Adolescent; Adult; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Equipment and Supplies; Female; Humans; Insulin; Insulin Infusion Systems; Male; Middle Aged; Prevalence; Retrospective Studies; Young Adult

Topics: Acrylates; Adolescent; Allergens; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Disposable Equipment; Female; Humans; Male; Patch Tests

Topics: Acrylates; Allergens; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 2; Female; Humans; Middle Aged

Adverse cutaneous reactions to diabetes medical devices (glucose sensors and insulin pumps) are described, notably allergic contact dermatitis (ACD) with isobornyl acrylate (IBOA) and N,N dimethylacrylamide (DMAA) as the main allergen.. To determine if all cases of adverse cutaneous reactions observed with diabetes medical devices (ie FreeStyle Libre, Enlite sensors or insulin pumps), referred to our department with suspected allergies are confirmed as ACD.. Fifty-two patients who presented skin reactions to diabetes medical devices were patch tested with the European baseline series, a plastic and glues series, a (meth) acrylates series, a piece of the adhesive part of the device, as well as IBOA 0.1% and DMAA 0.1% pet.. Seventeen patients had no positive reaction to IBOA nor to the adhesive part of the device; 11 of these also tested with DMAA with negative result. No other relevant allergen was identified.. Some cutaneous reactions, otherwise very similar to those of patients sensitized to IBOA, can be explained either by the presence of an untested allergen not yet discovered, or by irritant contact dermatitis. Therefore, European legislation on the full labelling of ingredients by manufacturers, in order to facilitate the identification of allergens and irritants, is imperative.

Topics: Acrylamides; Acrylates; Adhesives; Adolescent; Adult; Aged; Aged, 80 and over; Blood Glucose Self-Monitoring; Camphanes; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diabetes Mellitus; Equipment and Supplies; Female; Humans; Infusion Pumps, Implantable; Insulin Infusion Systems; Male; Middle Aged; Young Adult

Topics: Acrylates; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Patch Tests; Portugal; Tertiary Care Centers; Young Adult

Topics: Acrylates; Adhesives; Allergens; Antihypertensive Agents; Camphanes; Dermatitis, Allergic Contact; Epoprostenol; Female; Humans; Infusions, Subcutaneous; Middle Aged; Patch Tests; Pulmonary Arterial Hypertension

Topics: Acrylates; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Equipment and Supplies; Humans; Patch Tests

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

Diabetic devices including glucose monitoring systems and insulin pumps are used worldwide and are increasingly recognized as a source of irritant contact dermatitis and allergic contact dermatitis (ACD). Isobornyl acrylate is a chemical used in the glue of some of these devices and has been implicated as a frequent culprit allergen in patients who become sensitized to their device. Patch testing with isobornyl acrylate 0.1% in petrolatum is not necessary in standard screening panels but should be considered in patients with suspected ACD to glucose sensors or insulin pumps.

Topics: Acrylates; Allergens; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Humans; Patch Tests; United States

Topics: Acrylates; Arm; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Disease Management; Equipment and Supplies; Humans; Male; Middle Aged; Patch Tests

We present the case of an 8-year-old girl with type 1 diabetes who developed severe allergic contact dermatitis by using FreeStyle

Topics: Acrylates; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Humans; Hypoglycemic Agents; Prognosis

Isobornyl acrylate (IBOA) has recently been identified as one sensitizer in the FreeStyle Libre glucose sensor. Analyses with gas chromatography-mass spectrometry (GC-MS) have indicated the presence of N,N-dimethylacrylamide (DMAA) in the sensor.. Seven patients were referred for patch testing after developing skin reactions when using FreeStyle Libre. All patients were patch tested with IBOA and DMAA. Two patients were tested with adhesive patches that had been removed from the sensors "as is," and two patients were tested with acetone extracts of materials from the sensor. The extracts were analysed with GC-MS.. Six patients reacted to both IBOA and DMAA, and one patient reacted only to DMAA. Positive reactions were also observed in both patients tested with the adhesive patch "as is". One patient reacted to both an extract of the adhesive patch and an extract of the sensor itself. When analysed with GC-MS, IBOA was found in both extracts and DMAA was found in the extract of the sensor.. Both IBOA and DMAA may be present in adhesives used in medical devices such as glucose sensors or insulin pumps, and should be patch tested when suspected contact allergic reactions to these products are investigated.

Topics: Acrylamides; Acrylates; Adhesives; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Disease Management; Female; Humans; Male; Middle Aged

Glucose monitoring systems, for example, Freestyle Libre (Abott) and Dexcom (Nintamed), are increasingly being used instead of conventional blood sugar measurement. However, many patients have experienced adverse skin reactions such as severe allergic contact dermatitis (ACD). Finally, in August 2017, the culprit allergen in Freestyle Libre, isobornyl acrylate (IBOA), was identified.. After patients have developed ACD, it is recommended that they no longer use their glucose monitoring systems. Thus, it is important to find an alternative IBOA-free device.. Five patients presented with ACD caused by Freestyle Libre. Each was patch tested with allergens from the baseline series and from a plastics and glues series, and additionally with IBOA 0.1% pet. Gas chromatography-mass spectrometry (GC/MS) of the Freestyle Libre sensor and the Dexcom sensor was performed. The Dexcom sensor remained on the skin of all patients for at least 2 days.. All patients were sensitized to IBOA. GC/MS showed the presence of IBOA in the Freestyle Libre sensor, whereas the Dexcom sensor was IBOA-free. None of the patients had skin reactions to the Dexcom sensor.. Patients with Freestyle Libre and IBOA allergy may use the Dexcom sensor as an alternative for glucose monitoring.

Topics: Acrylates; Adhesives; Adult; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Middle Aged

Topics: Acrylates; Bandages, Hydrocolloid; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Humans; Male

Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series.. To compile patch test results of subjects affected, and provide potential explanations for this association.. Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM.. Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA.. Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist.

Topics: Acrylates; Adolescent; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Child; Child, Preschool; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Gas Chromatography-Mass Spectrometry; Humans; Male; Middle Aged; Patch Tests; Sesquiterpenes; Young Adult

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

Topics: Acrylates; Adult; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Disposable Equipment; Female; Humans; Middle Aged; Patch Tests

Topics: Acrylates; Adolescent; Adult; Allergens; Blood Glucose; Camphanes; Child; Cohort Studies; Dermatitis, Allergic Contact; Equipment and Supplies; Female; Humans; Incidence; Infusion Pumps; Insulin; Male; Middle Aged; Patch Tests; Prognosis; Risk Assessment

Topics: Acrylates; Adult; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Female; Humans; Hypopigmentation

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

In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA). Subsequently they showed by means of gas chromatography-mass spectrometry that this substance is present in the case of the glucose sensor attached by an adhesive to the skin. We report three additional cases from Germany, including a 10-year-old boy, suffering from severe allergic contact dermatitis to IBOA.

Topics: Acrylates; Adhesives; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Humans; Male

The frequency of allergic contact dermatitis caused by (meth)acrylates is increasing worldwide, and isobornyl acrylate (IBOA) has been identified as a culprit sensitizer in FreeStyle Libre, a medical device used by diabetic patients.. To report on 4 patients sensitized to IBOA contained in OmniPod, a new, tubeless insulin pump, and to describe the clinical and chemical analytical work-up.. Four patients with eczematous skin eruptions after using OmniPod, including 2 with previous adverse skin reactions to FreeStyle Libre, were patch tested with a baseline series and additional (meth)acrylates, including IBOA in several concentrations and/or vehicles. Gas chromatography-mass spectrometry (GC-MS) was used to identify the presence of IBOA in OmniPod.. All patients were shown to be sensitized to IBOA. GC-MS identified IBOA in OmniPod, with the highest concentrations being found in the unit itself and not in the adhesive patch.. The OmniPod tubeless insulin pump is another source of IBOA, and its use may lead to primary sensitization to this acrylate, or may provoke elicitation of allergic contact dermatitis in previously sensitized patients. Our cases highlight the need to obtain satisfactory cooperation from pharmaceutical companies involved in the manufacture of these widely used medical devices.

Topics: Acrylates; Adhesives; Adolescent; Adult; Aged; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Female; Humans; Insulin Infusion Systems; Middle Aged; Patch Tests

Topics: Acrylates; Administration, Cutaneous; Camphanes; Child; Dermatitis, Allergic Contact; Humans; Hypoglycemic Agents; Insulin; Male; Transdermal Patch

Topics: Acrylates; Adult; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Equipment and Supplies; Humans; Male

Glucose sensors, such as FreeStyle® Libre, are innovative medical devices developed for diabetes patients as a replacement for classic glucose meters, ensuring continuous glucose monitoring without the disadvantage of regular skin finger pricks.. To report several cases of allergic contact dermatitis caused by FreeStyle® Libre, and to report on isobornyl acrylate as a culprit allergen.. Fifteen patients presented with allergic contact dermatitis caused by FreeStyle® Libre. All but 1 were patch tested with a baseline series, and with pieces and/or ultrasonic bath extracts of (the adhesive part of) the glucose sensor. Isobornyl acrylate was patch tested, in various concentrations and vehicles, in 13 patients. Gas chromatography-mass spectrometry (GC-MS) of the sensors was performed.. All patients reacted to the adhesive part of the sensor, and 12 patients were shown to be sensitized to isobornyl acrylate. Simultaneous reactions to other allergens were rarely observed. GC-MS showed the presence of isobornyl acrylate in the sensors.. Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.

Topics: Acrylates; Administration, Cutaneous; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Gas Chromatography-Mass Spectrometry; Humans

Alkyl glucosides and alkyl poly-glucosides are widely used as wetting agents, surfactants and emulsifiers in several industrial and cosmetic products. They are known as well-tolerated and are usually added to the primary surfactants in order to reduce the irritating potential of the main foaming agents.. Recently, some authors suggested that allergic contact dermatitis to alkyl glucosides might be more frequent than suspected. On the other hand, the chemical structures of glucosides do not show potentially allergenic chemical groups or strongly polarized structures. The aim of our study is to investigate alkyl glucosides carrying out a detailed chemical analysis on samples of raw materials to identify potentially allergenic impurities or by-products contained in commercial samples of alkyl glucosides.. We chemically analyzed samples of cocoyl glucoside, decyl glucoside and lauryl glucoside by three different analytical methods, in order to identify any undesired or polluting substances.. In each of the three samples, we detected the presence of isobornyl acrylate. Its approximate content in the tested samples is 500 ng/g of the product.. Isobornyl acrylate is not used in the synthesis of alkyl glucosides, but as a plasticizer in many plastic materials. It can be easily released to materials flowing over these surfaces when they have high extraction power, as glucosides.. Isobornyl acrylate may play a role as hidden allergen, in the form of an impurity collected during the industrial process, explaining some cases of allergic reaction to alkyl glucosides.

Topics: Acrylates; Allergens; Camphanes; Dermatitis, Allergic Contact; Glucosides; Plasticizers; Surface-Active Agents

Acrylates constitute an important cause of occupational contact dermatitis. Isobornyl acrylate sensitization has been reported in only 2 cases. We encountered an industrial process operator with occupational contact dermatitis caused by isobornyl acrylate.. (i) To investigate whether it is relevant to add isobornyl acrylate to the (meth)acrylate test series. (ii) To report patients with (meth)acrylate contact allergy at an occupational dermatology clinic.. Our patch test database was screened for positive reactions to (meth)acrylates between 1993 and 2012. A selected group of 14 patients was tested with an isobornyl acrylate dilution series: 0.3%, 0.1%, 0.033%, and 0.01%. Readings were performed on D2, D3, and D7.. One hundred and fifty-one patients were tested with our (meth)acrylate series; 24 had positive reactions. Most positive reactions were to 2-hydroxypropyl acrylate, 2-hydroxyethyl acrylate, 2-hydroxypropyl methacrylate, and diethyleneglycol diacrylate. Hypothetical screening with 2-hydroxypropyl acrylate, ethyleneglycol dimethacrylate, ethoxylated bisphenol A glycol dimethacrylate and trimethylolpropane triacrylate identified 91.7% of the 24 patients. No positive reactions were observed in 14 acrylate-positive patients tested with the isobornyl acrylate dilution series. The 0.3% isobornyl acrylate concentration induced irritant reactions in 3 patients.. We report a rare case of allergic contact dermatitis caused by isobornyl acrylate. However, this study provides insufficient support for isobornyl acrylate to be added to a (meth)acrylate series.

Topics: Acrylates; Adult; Aged; Allergens; Camphanes; Dermatitis, Allergic Contact; Dermatitis, Occupational; Female; Hand Dermatoses; Humans; Male; Methacrylates; Middle Aged