Intense skin reaction to a new glucose monitoring and insulin pump system

Abstract

Avoidance of nickel and colophonium was initiated: the metalbracket chin-pad was replaced by a chin-pad with plastic brackets and she began to use a hypoallergic artificial rosin oil without colophonium. After treating the existing lesions with topical corticosteroids and the start of the avoidance measures, no recurrence was observed during 6 months follow-up. DISCUSSION ACD results in a considerable burden in professional musicians. Several case reports described ICD ("fiddler's neck" type 1) while others reported sensitization to colophonium used on the bow. To our knowledge, this is the first case reporting concomitant sensitization to nickel ("fiddler's neck" type 2) and colophonium in a professional musician. 5,6 This case illustrates the need to consider more than one sensitization when one allergen does not explain all the symptoms. Many allergens may be present in the metals and woods of instruments; however, recent studies indicate that ACD, as an occupational skin disease, is a rare diagnosis in musicians. 7 Large scale epidemiological studies are required to learn if multiple sensitizations are frequent among musicians and which allergens pose the highest risks and in which instruments. Musicians, instrument manufacturers, and physicians may consider measures to identify and avoid frequent allergens.

Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy‐ prone’ devices: investigation and advice hampered by insufficient material for optimized patch test investigations

“…Such a pattern of reactivity might have indicated a possibility of a colophony‐related culprit contact allergen in Dexcom G6. Different colphony derivatives may be used as tackifiers in pressure‐sensitive acrylate‐based adhesives 26,31 . The GC‐MS analyses indicated the presence of methyldehydroabietate in the extract of the adhesive patches, which in turn indicate the presence of colophony.…”

“…The extracts were analysed by gas chromatography‐mass spectrometry 26 . Dilutions of IBOA in acetone were used as reference standards.…”

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

“…Case 2 was further exposed to IBOA through the use of Omnipod 21 and was most likely thereby sensitized to colophony and hydroabietyl alcohol, causing allergic contact dermatitis almost instantly when using the Medtrum devices. 4 The three cases are particularly interesting since they could at first use the device without experiencing any skin problems, in cases 2 and 3, even for a prolonged time, and then experienced dermatitis. The fact that we know from previous investigations and the investigations reported here that in Dexcom G6 2 both IBOA and possibly colophony-related substances are present, but presumably in our cases the concentration did not initially initiate an elicitation.…”

“…She was investigated because of contact dermatitis and found to have an allergic contact dermatitis. 4 Because of the multiple contact allergies found in the earlier investigation (Table 1), and the fact that the patient now had started having symptoms from Dexcom G6, she was once more referred for patch testing.…”

Occupational allergic contact dermatitis to dibutyl maleate and dibutyl fumarate present in a safety shoe: A reason for concern?

“…Analysis of the two extracts using gas chromatography–mass spectrometry 5 showed that both samples contained DBM and DBF. The presence was confirmed by analysis of the pure substances.…”