Contact Dermatitis to Diabetes Medical Devices

Abstract

Skin adverse reactions to diabetes medical devices have been reported frequently over recent years. Adhesives attaching glucose sensors and continuous insulin infusion sets to the skin are proven to cause both allergic contact dermatitis and irritant contact dermatitis in patients with diabetes mellitus. Several allergens contained in adhesives and/or parts of medical devices are documented to cause allergic contact dermatitis, with acrylate chemicals being the most common culprit-especially isobornyl acrylate (IBOA), but also 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate or cyanoacrylates. Epoxy resin, colophonium and nickel were also identified as causative allergens. However, repetitive occlusion, maceration of the skin and resulting disruption of the skin barrier seem to have an impact on the development of skin lesions as well. The purpose of this study is to highlight the burden of contact dermatitis triggered by diabetes medical devices and to show possible mechanisms responsible for the development of contact dermatitis in a group of diabetic patients.

Allergic contact dermatitis and irritant contact dermatitis from medical devices used by patients with insulin‐dependent diabetes mellitus

“…The gold standard in the diagnosis of allergic contact dermatitis (ACD) is patch testing. 1 When ACD is suspected to be connected to diabetes medical devices, baseline series, plastics, glues and acrylate-series patch tests, including isobornyl acrylate (IBOA), should be considered. ACD to adhesive chemicals in diabetic devices, including colophonium, modified colophonium, epoxy and acrylates, has recently garnered the attention of contact dermatitis groups around the world.…”

“…Manufacturers usually do not provide a list of exact chemicals contained in the devices or generally state that 'polyacrylates' are present without specification. 1 von Kobyletzki et al highlighted that there is a significant research gap in this topic. The authors emphasized the need for improved knowledge about the chemical substances contained in these devices, better regulation on full labelling and improvement of the commercially available allergens for testing.…”

“…However, it is important to remember that hydrocolloid dressings may equally contain modified colophonium that might elicit reactions in sensitized patients. 1,3…”