New device, 'old' allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor.
Dexcom G7
allergic contact dermatitis
case report
colophonium
glucose sensor
glyceryl hydrogenated rosinate
hydroabietyl alcohol
isobornyl acrylate
medical device
methyl hydrogenated rosinate
rosin
Journal
Contact dermatitis
ISSN: 1600-0536
Titre abrégé: Contact Dermatitis
Pays: England
ID NLM: 7604950
Informations de publication
Date de publication:
05 Feb 2024
05 Feb 2024
Historique:
revised:
12
01
2024
received:
11
12
2023
accepted:
22
01
2024
medline:
6
2
2024
pubmed:
6
2
2024
entrez:
5
2
2024
Statut:
aheadofprint
Résumé
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. To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. 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). 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor.
PATIENTS AND METHODS
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
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
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Jan Hains stiftelse för vetenskaplig klinisk medicinsk forskning
Organisme : Svenska Diabetesstiftelsen
Organisme : Astma- och Allergiförbundet
Organisme : HudFonden
Informations de copyright
© 2024 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.
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