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- Comstedt, Lisbeth Rosholm, et al.
(author)
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Effects of aluminium chloride added to common patch test substances
- 2023
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 88:6, s. 456-462
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Journal article (peer-reviewed)abstract
- Background: A modulating effect of aluminium regarding type IV reactions might exist but has not been further investigated. Objectives: The aim of this study was to investigate the effect on patch test reactions when adding aluminium chloride hexahydrate (Al-Cl) to common test preparations. Materials and methods: Al-Cl in different concentrations was added to nickel sulphate 15.0% aqua (Ni), methylisothiazolinone 0.2% aqua (MI) and fragrance mix I 10.0% aqua/ethanol (FM I). The Ni preparations were tested in 120 consecutive patients. MI and FM I were tested in participants known to have contact allergy to the respective allergen. McNemar's test was used to decide which Ni preparation had the highest sensitivity. Wilcoxon signed-rank test was used to calculate pairwise comparison in summarized test score for the preparations with MI and FM I. Results: Adding Al-Cl 20.0%/30.0% to Ni identified twice as many patients with contact allergy to nickel compared to Ni without Al-Cl. Adding Al-Cl 20.0%/10.0% to MI, decreased the patch test reactivity compared to MI without Al-Cl. No differences in patch reactivity were noticed when adding Al-Cl to FM I. Conclusion: Al-Cl 20.0% or 30.0% seems to enhance the patch test reactivity to Ni 15.0% aqua.
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- Mowitz, Martin, et al.
(author)
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New device, ‘old’ allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor
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In: Contact Dermatitis. - 0105-1873.
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Journal article (peer-reviewed)abstract
- Background: Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. Objectives: To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Patients and Methods: Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium – methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography–mass spectrometry (GC–MS). Results: Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC–MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. Conclusions: Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.
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- Siemund, Ingrid, et al.
(author)
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Allergic contact dermatitis due to 1,6-hexanediol diacrylate in ostomy patients
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In: Contact Dermatitis. - 0105-1873.
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Journal article (peer-reviewed)abstract
- Background: Many people live with ostomies after life-saving surgery. Ostomy patients often suffer from peristomal dermatitis. Allergic contact dermatitis (ACD) has been reported, mostly due to contact allergy (CA) to topical agents. Objectives: We present three patients with therapy resistant peristomal dermatitis, suggesting ACD caused by different stoma products. Methods: Patch testing was performed with baseline series, additional series, and selected allergens. They were also tested with their own ostomy products as is and separate extracts of the products. Extracts were analysed using Gas Chromatography–Mass Spectrometry (GC–MS). Results: In all three patients we diagnosed CA to 1,6-hexanediol diacrylate (HDDA), +++ in case (C) 1 and 3, ++ in C 2. HDDA was detected in C 2's ostomy pouch adhesive and in C 1's and 3's flange extenders used to improve the adhesion of the ostomy pouches. Conclusion: Therapy resistant peristomal dermatitis should always be suspected of ACD and patch testing, especially with the patient's own products, should be performed.
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