Allergic Eosinophilic Dermatitis Due to Silicone Rubber: A Rare but Troublesome Complication of the Tenckhoff Catheter

Abstract

A 42-year-old Japanese woman developed an eczematous skin rash around the catheter exit during continuous ambulatory peritoneal dialysis (CAPD). The same kind of lesion developed around a Scribner shunt exit. Skin biopsy indicated chronic eosinophilic dermatitis. In the patch test she developed an allergic reaction to the silicone rubber catheter but not to the antiseptic solutions. Based on these findings, we concluded that her “eczematous” rash represented an allergic response to silicone rubber in the peritoneal catheter. To this date the literature contains no reports of such a catheter complication in CAPD. Catheter complications in patients on CAPD are mainly infection and mechanical dysfunction such as poor drainage or leaks (I, 2). Eosinophilic dermatitis around the catheter exit caused by the silicone rubber is extremely uncommon (3). As yet no reports have been published concerning this rare catheter complication.

Pruritic Rash and Eosinophilia in a Patient Receiving Peritoneal Dialysis

“…In the case report by Kurihara, the patient had contact dermatitis only at the exit site of the Tenckhoff catheter (5). In addition, that patient exhibited only modest peripheral eosinophilia (380-745 ⁄ mm 3 ).…”

Subcutaneous granulomatous reaction with eosinophil infiltration to a silicone continuous ambulatory peritoneal dialysis Tenckhoff catheter

“…One case each of contact dermatitis and systemic allergic dermatitis was diagnosed by skin patch tests for peritoneal catheters, but histological information about skin patch test reactions was not provided. 1,2 Our case presented with a subcutaneous granulomatous reaction with eosinophil infiltration, but with no epidermal spongiosis observed typically in contact dermatitis. We therefore diagnosed our case as possible allergic granulomatous reaction to the Tenckhoff catheter.…”

Noninfectious Peritoneal Dialysis Exit Site Rash—An Unusual Case Report and Review of the Literature

“…2017 6 Octenisept Expanding erythematous rash Avoiding the responsible allergen 1 Kurihara et al . 1985 7 Silicone rubber Eczematous skin rash Antihistaminic ointment and insert a piece of gauze under the lesion …”