Clinical consequences of sesquiterpene lactone mix contact allergy in Denmark

Andersen, Rikke Sand; Skov, Lone; Menné, Torkil; Johansen, Jeanne Duus

doi:10.1111/bjd.13584

Cited by 4 publications

(7 citation statements)

References 13 publications

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“…Furthermore, even long‐standing Compositae dermatitis may be manageable with topical steroids if exposure to strongly sensitizing plants is avoided (case 6), and this has also been reported previously from, for example, Australia . Thus, Compositae‐allergic patients suffering from severe summer exacerbations despite avoidance of plant contact may not suffer because of the allergy, but because of a constitutional hand eczema becoming worse in summer, possibly with superimposed photosensitivity . Inadvertent indirect contact may, of course, be another contributing factor to the exacerbation, and should be managed through patient education.…”

Section: Discussionmentioning

confidence: 67%

Clinical patterns of Compositae dermatitis in Danish monosensitized patients

Paulsen

Andersen

2017

Contact Dermatitis

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The prevalence of Compositae sensitization is continuously high in consecutive eczema patients. Sensitization may occur at any age. Clinical features in monosensitized patients vary, but, with continuing exposure, the patients may develop more widespread dermatitis similar to classic Compositae dermatitis. Avoidance may clear the exogenous part, but not endogenous aetiological factors such as vesicular hand eczema or possible photosensitivity. Thorough clinical assessment and patient education are important in reducing the impact of Compositae contact allergy.

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Section: Discussionmentioning

confidence: 67%

Clinical patterns of Compositae dermatitis in Danish monosensitized patients

Paulsen

Andersen

2017

Contact Dermatitis

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“…SLs constitute a group of terpenoids that are present in several plant families, including the Lauraceae, Magnoliaceae, and Compositae, the last of which is the largest family. In most cases of ACD, sensitization from SLs has been caused by cosmetics, pharmaceutical products, herbal medicines, flower handling, or consumption of SL‐containing plants . Some SLs are characterized by an α‐methylene‐γ‐butyrolactone ring (Figure ).…”

Section: Discussionmentioning

confidence: 99%

“…In most cases of ACD, sensitization from SLs has been caused by cosmetics, pharmaceutical products, herbal medicines, flower handling, or consumption of SL-containing plants. 6 Some SLs are characterized by an α-methyleneγ-butyrolactone ring ( Figure 2). Such structures and, notably, the α,β-unsaturated carbonyl chemical functional group have been shown to be good electrophiles that undergo covalent binding with nucleophilic residues of skin proteins via 1,4-addition or Michael addition, which is responsible for their sensitizing potential.…”

Section: Discussionmentioning

confidence: 99%

“…10 Interestingly, within a country, significant differences between the percentages of simultaneous reactions to SLM and Compositae mix can be observed. 11 The prevalence of sensitization to SLs (based on the SLM patch tests) observed in European patch test clinics ranges from 0.1% to 2.0%, 6,12 and it was estimated to be 0.1% in the European general population. 13 Among the 53 patients tested for ACD caused by the glucose sensor FreeStyle Libre, IBOA, or both, more than half (62.3%) showed sensitization to SLs, which accounts for the increased prevalence of sensitization observed in the three contact allergy units involved in this study.…”

Section: Discussionmentioning

confidence: 99%

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Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre

et al. 2019

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Background: 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. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: 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. Results: 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. Conclusion: 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. K E Y W O R D S allergic contact dermatitis, chemical analysis, diabetes mellitus, FreeStyle Libre, GC-MS, glucose sensor, isobornyl acrylate, medical device, sesquiterpene lactones, simultaneous reactions

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“…This was unexpected while the prevalence rate of sensitization to SL (based on the SLM patch tests) observed in European patch test clinics ranges from 0.1 to 2.0%. 13,14 In order to better understand this co-sensitization, several analyses were performed, including patch tests with all the component of the SLM. In the present study, 5/12 children (41.7%) were positive to SLM; three patients were tested with the three components of SLM (alantolactone, costunolide, and dehydrocostus lactone).…”

Section: Methodsmentioning

confidence: 99%

Contact dermatitis caused by glucose sensors in diabetic children

et al. 2019

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Background 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. Objectives 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. Patients and Methods 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. Results 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. Conclusion 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.

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Clinical consequences of sesquiterpene lactone mix contact allergy in Denmark

Cited by 4 publications

References 13 publications

Clinical patterns of Compositae dermatitis in Danish monosensitized patients

Clinical patterns of Compositae dermatitis in Danish monosensitized patients

Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre

Contact dermatitis caused by glucose sensors in diabetic children

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