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New device, ‘old’ allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor

Mowitz, Martin LU ; Hosseini, Sarah ; Siemund, Ingrid LU ; Ulriksdotter, Josefin LU orcid and Svedman, Cecilia LU (2024) In Contact Dermatitis
Abstract

Background: Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. Objectives: To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Patients and Methods: Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium – methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients... (More)

Background: Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. Objectives: To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Patients and Methods: Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium – methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography–mass spectrometry (GC–MS). Results: Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC–MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. Conclusions: Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
allergic contact dermatitis, case report, colophonium, Dexcom G7, glucose sensor, glyceryl hydrogenated rosinate, hydroabietyl alcohol, isobornyl acrylate, medical device, methyl hydrogenated rosinate, rosin
in
Contact Dermatitis
publisher
Wiley-Blackwell
external identifiers
  • pmid:38316128
  • scopus:85184263429
ISSN
0105-1873
DOI
10.1111/cod.14514
language
English
LU publication?
yes
id
8f59da20-1405-4108-893e-790a28ebd138
date added to LUP
2024-03-08 14:33:35
date last changed
2024-04-20 08:19:48
@article{8f59da20-1405-4108-893e-790a28ebd138,
  abstract     = {{<p>Background: Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. Objectives: To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Patients and Methods: Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium – methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography–mass spectrometry (GC–MS). Results: Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC–MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. Conclusions: Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.</p>}},
  author       = {{Mowitz, Martin and Hosseini, Sarah and Siemund, Ingrid and Ulriksdotter, Josefin and Svedman, Cecilia}},
  issn         = {{0105-1873}},
  keywords     = {{allergic contact dermatitis; case report; colophonium; Dexcom G7; glucose sensor; glyceryl hydrogenated rosinate; hydroabietyl alcohol; isobornyl acrylate; medical device; methyl hydrogenated rosinate; rosin}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Contact Dermatitis}},
  title        = {{New device, ‘old’ allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor}},
  url          = {{http://dx.doi.org/10.1111/cod.14514}},
  doi          = {{10.1111/cod.14514}},
  year         = {{2024}},
}