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
Malmö, SUS. First published: 08 October 2020 Journal of European Academy of Deramtology and Venerology, Oct 2020
Medical devices are increasingly being reported to cause contact allergic dermatitis reactions.
Review of patients with diabetes type I referred for suspected allergic contact dermatitis to insulin pump or glucose sensor systems. Method: We have reviewed 11 referred diabetes mellitus patients investigated for allergic contact dermatitis reactions to medical devices and specifically Dexcom G6®. Extracts from the medical devices were analysed.
The majority of patients was children, the majority had relevant allergies and particularly allergy to isobornyl acrylate which was also found in the glucose sensor system Dexcom G6®.
The following case reports bring in focus the fact that patients sensitized through use of one medical device and being advised the use of another, or find another product for a while useful, are not by necessity free from future episodes of allergic contact dermatitis.
The case reports emphasize the need for collaboration since it is impossible for even well‐equipped laboratories to properly investigate the medical devices when information on the substances used in production is not uniform and complete and material to investigate are scarce.
The importance of adequate patch test series and testing with own material and furthermore the importance to re‐analyse medical devices and re‐analyse test data are emphasized.
Allergic contact dermatitis caused by glucose sensors in type 1 diabetes patients
. 2019 Sep;81(3):161-166.
doi: 10.1111/cod.13337. Epub 2019 Jul 10.
Background: Allergic contact dermatitis caused by glucose sensors has become an increasing problem. Contact allergies to isobornyl acrylate, colophonium, ethyl cyanoacrylate and N,N-dimethylacrylamide have been reported. However, there is a paucity of information regarding the prevalence of sensor-related dermatitis and detailed patient histories.
Objectives: To evaluate diabetes patients who have developed allergic contact dermatitis caused by glucose sensors.
Patients and methods: Seventy patients with suspected contact allergy to glucose sensors referred to university hospital dermatology clinics in southern Finland were patch tested with the baseline series, an isobornyl acrylate dilution series, and a number of other acrylates. Atopic constitution, contact allergies, the severity of the dermatitis and the ability to continue with the same or another type of sensor were recorded.
Results: Positive patch test reactions to isobornyl acrylate were seen in 51 of 63 (81%) Freestyle Libre users. Colophonium or its derivatives gave positive reactions in five of seven Medtronic Enlite users. The median duration of sensor use before dermatitis was 6 months. The estimated prevalences of contact allergy to sensor adhesives were 0.7% for Freestyle Libre and 0.8% for Enlite.
Conclusions: We suggest that patients who have difficulties in finding a tolerable glucose sensor or an insulin pump should be patch tested.
Keywords: CAS no. 5888-33-5; acrylates; adhesives; allergic contact dermatitis; glucose sensors; isobornyl acrylate; medical device; type 1 diabetes.
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