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Changes in adhesive ingredients in continuous glucose monitoring systems may induce new contact allergy pattern

Svedman, Cecilia LU ; Ulriksdotter, Josefin LU orcid ; Lejding, Tina LU orcid ; Bruze, Magnus LU and Mowitz, Martin LU (2021) In Contact Dermatitis 84(6). p.439-446
Abstract

Background: 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. Objectives: 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. Methods: 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. Results: The patients were sensitized to isobornyl acrylate (IBOA), found in previously... (More)

Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
2,2'-methylenebis(6-tert-butyl-4- methylphenol) monoacrylate, allergic contact dermatitis, contact allergy, diabetes type I, gas chromatography-mass spectrometry glucose monitoring (CGM) systems, isobornyl acrylate medical device
in
Contact Dermatitis
volume
84
issue
6
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:33421157
  • scopus:85099825103
ISSN
0105-1873
DOI
10.1111/cod.13781
language
English
LU publication?
yes
id
9f1ed5cb-1de8-409a-a3ce-a3db95c5b394
date added to LUP
2022-03-01 15:22:34
date last changed
2024-06-27 12:38:31
@article{9f1ed5cb-1de8-409a-a3ce-a3db95c5b394,
  abstract     = {{<p>Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.</p>}},
  author       = {{Svedman, Cecilia and Ulriksdotter, Josefin and Lejding, Tina and Bruze, Magnus and Mowitz, Martin}},
  issn         = {{0105-1873}},
  keywords     = {{2,2'-methylenebis(6-tert-butyl-4- methylphenol) monoacrylate; allergic contact dermatitis; contact allergy; diabetes type I; gas chromatography-mass spectrometry glucose monitoring (CGM) systems; isobornyl acrylate medical device}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{439--446}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Contact Dermatitis}},
  title        = {{Changes in adhesive ingredients in continuous glucose monitoring systems may induce new contact allergy pattern}},
  url          = {{http://dx.doi.org/10.1111/cod.13781}},
  doi          = {{10.1111/cod.13781}},
  volume       = {{84}},
  year         = {{2021}},
}