Allergic contact dermatitis caused by wound closure tape in a pediatric patient

Tam, Idy; Yu, Jin‐Chen

doi:10.1111/pde.14084

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…[128][129][130][131] This allergen is often found in the adhesive portion of insulin pumps and glucose sensors. 132 In patients with diabetes referred for patch testing because of suspected ACD to Freestyle Libre (Abbott, Chicago, Illinois), 81% of patients had a PPT to IBOA. 133 IBOA was the ACDS Allergen of the Year in 2020.…”

Section: Emerging Pediatric Allergensmentioning

confidence: 99%

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Neale

Garza-Mayers

Tam

et al. 2021

Journal of the American Academy of Dermatology

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Allergic contact dermatitis (ACD), a delayed hypersensitivity skin reaction to environmental allergens, has a prevalence that is similar in children and adults. However, diagnostic testing for ACD in pediatric populations accounts for less than one tenth of all patch tests. The relative infrequency of pediatric patch testing may be attributed to the difficulty in testing in this population, which includes a smaller surface area for patch test placement and maintaining cooperation during patch testing, especially in younger children. Diagnosis can be difficult in children because the appearance of ACD can mimic other common pediatric skin conditions, particularly atopic dermatitis and irritant contact dermatitis. Comprehensive history taking, guided by patient presentation, age group, and location of dermatitis, helps build clinical suspicion. Such clinical suspicion is one of the major reasons behind patch testing, with additional indications being recalcitrant dermatitis and dermatitis with atypical distribution. US pediatric data have shown the top allergens to be metals, fragrances, topical antibiotics, preservatives, and emollients. These trends are important to recognize to guide management and accurate diagnosis, because ACD tends to persist if the allergen is not identified and can affect patients' quality of life.

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Section: Emerging Pediatric Allergensmentioning

confidence: 99%

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Neale

Garza-Mayers

Tam

et al. 2021

Journal of the American Academy of Dermatology

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“…was identified in a wound closure tape, probably Steristrip, 2 there have also been one more publication with an allergic reaction to this product, but no allergen was identified in the tape. 13 The patient that reacted to the EMLA local anaesthetic patch had a three-plus reaction to the patch when tested as is. However, this patient was also positive to prilocaine, the active substance in the EMLA patch, with + reaction to prilocaine 5% pet.…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, no patch testing with 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol) was performed, but it may also be a possible cause of dermatitis. Except for the report where 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol) was identified in a wound closure tape, probably Steristrip, 2 there have also been one more publication with an allergic reaction to this product, but no allergen was identified in the tape 13 …”

Section: Discussionmentioning

confidence: 99%

4,4′‐Thiobis(2‐tert‐butyl‐5‐methylphenol), an antioxidant in medical devices that may cause allergic contact dermatitis

et al. 2023

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Background Antioxidants in medical devices, added to protect polymers or adhesives, may also cause contact dermatitis in some individuals. Objectives To present data on sensitization to 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol), an antioxidant detected in some types of medical devices, for six patients that experienced eczematous reactions to different medical devices. Methods Patch testing with 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol), 1% pet was performed. Gas chromatography‐mass spectrometry (GC‐MS) was used for identification of 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol) in different medical device products. Results Six patients with contact allergy to 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol) also had relevant contact allergic reactions to medical devices containing the antioxidant. The presence of the antioxidant in products was detected using GC‐MS analysis. Conclusions The antioxidant 4,4′‐thiobis(2‐tert‐butyl‐5‐methylphenol) may cause allergic contact dermatitis after exposure to different medical devices.

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“…3,4 Periwound skin changes are a significant quality-of-life issue for patients, 5 and unrecognized and untreated periwound dermatitis slows wound healing. 6 Correct and timely recognition and treatment of the causes of periwound dermatitis are an essential skill for wound clinicians, requiring an understanding of the normal function of the skin as a barrier and the reaction patterns produced when the skin barrier fails. 7 In this article, the author outlines the recognition and differential diagnosis of ACD, discusses the role of the skin barrier function, lists the most common sources of allergenic substances associated with ACD, and offers an algorithm for patients who present with dermatitis and a history of LLUs.…”

Section: Introductionmentioning

confidence: 99%

“…The probability of developing allergic CD (ACD) increases with the duration of venous leg disease and the incidence of sensitization overall; it is more prevalent in patients with venous leg ulcers (VLUs) 3,4 . Periwound skin changes are a significant quality-of-life issue for patients, 5 and unrecognized and untreated periwound dermatitis slows wound healing 6 . Correct and timely recognition and treatment of the causes of periwound dermatitis are an essential skill for wound clinicians, requiring an understanding of the normal function of the skin as a barrier and the reaction patterns produced when the skin barrier fails 7 …”

Section: Introductionmentioning

confidence: 99%

What Is the Role of Allergic Contact Dermatitis in Patients with Lower Leg Ulcers?

Parsons

2023

Adv Skin Wound Care

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Lower leg ulcers are a common clinical presentation to wound care clinics. They are often associated with the presence of dermatitis on the periwound skin, which can be a factor in delayed wound healing. Correctly diagnosing the underlying etiology is critical to reversing the breakdown in the skin barrier function. The author discusses allergic contact dermatitis as an etiology and describes the most common allergens, fragrances, and preservatives identified from a limited literature review. Patch testing is the criterion standard for the diagnosis of allergic contact dermatitis and is the most appropriate means of identifying causative allergens. An algorithm for the identification and treatment of lower leg dermatitis is provided to simplify the process. GENERAL PURPOSE To analyze the relationship between contact dermatitis and delayed wound healing, discuss the diagnosis and treatment of lower leg contact dermatitis, and provide an algorithm for the patient with a red leg and delayed wound healing. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Describe the nature of contact dermatitis. 2. Distinguish between allergic and irritant contact dermatitis and the other major differential diagnoses of delayed wound healing in this clinical scenario. 3. Outline the steps in the diagnosis of allergic contact dermatitis and irritant contact dermatitis and identify common haptens responsible for allergic contact dermatitis in patients with venous leg ulcers. 4. Apply the algorithm for delayed wound healing on a background of lower leg dermatitis.

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Allergic contact dermatitis caused by wound closure tape in a pediatric patient

Cited by 6 publications

References 6 publications

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

4,4′‐Thiobis(2‐tert‐butyl‐5‐methylphenol), an antioxidant in medical devices that may cause allergic contact dermatitis

What Is the Role of Allergic Contact Dermatitis in Patients with Lower Leg Ulcers?

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