Cases Of Allergic Contact Dermatitis Research Articles

Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way.

Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.

Allergic Contact Dermatitis to Octyl Cyanoacrylate Skin Glue After Surgical Wound Closure: A Systematic Review.

The rising incidence of allergic contact dermatitis (ACD) after cyanoacrylate adhesive use necessitates a comprehensive understanding of its clinical presentations, risk factors, and management. In this systematic review, we conducted an exhaustive search following PRISMA guidelines within Medline and PubMed databases to identify studies reporting cases of ACD resulting from cyanoacrylate adhesive application in wound closure. A total of 47 studies, covering 193 ACD cases, were included in our analysis. These cases involved 35 male, 120 female patients, and 38 cases without gender information (M:F ratio = 1:3.43), with ages ranging from 7 to 92 years (mean age 43.9 years). The majority of cases (n = 140) were part of 6 orthopedic studies, focusing on joint replacements (n = 68), orthopedic surgeries (n = 38), and breast surgeries (n = 29). The remaining 58 cases encompassed various surgical procedures. Common clinical manifestations included swelling, pruritic rash, erythema, vesicles, and itching around the surgical sites, typically appearing around 10 days post-adhesive application (within a range of 6 hours to 6 weeks). Patients with prior exposure to 2-octyl cyanoacrylate tended to exhibit earlier symptoms. Similar rates of dermatitis were observed across different adhesive brands, suggesting brand independence. Treatment strategies involved adhesive removal, administration of steroids and antihistamines, meticulous wound care, and, in some cases, surgical intervention. Notably, 3.1% of the 193 cases required surgical intervention. Risk factors, including a history of atopic dermatitis, high body mass index, diabetes, prior adhesive exposure, and surgical history, were identified in the studies. Patch tests confirmed 2-octyl cyanoacrylate as the allergen in 21 studies. Our review aims to enhance health care professionals' understanding of ACD resulting from the use of cyanoacrylate adhesive, facilitating improved postsurgical management and prevention strategies. Recognizing diverse risk factors, understanding varying clinical presentations, distinguishing ACD from infection, and employing appropriate treatment approaches are essential for achieving optimal outcomes in such cases.

Exploring the relationship between allergic contact dermatitis and atopic dermatitis in children: insights from a retrospective patch testing analysis.

Recent years have seen significant exploration into the potential link between allergic contact dermatitis and atopic dermatitis, yielding contradictory findings. A retrospective cohort analysis of children aged 2 to 18 who underwent patch testing at the pediatric dermatology clinic at a tertiary medical center in Israel was conducted. Overall, 367 patients were included in the study, 31.6% of whom were diagnosed with atopic dermatitis. 160 children (43.6%) exhibited a positive reaction to at least one compound in the European baseline series. There was no statistically significant difference in reactivity between children with atopic dermatitis and those without (P = 0.848). Sub-analyses based on ethnicity, gender, and age did not reveal significant differences in overall European baseline series reactivity (P = 0.612, P = 0.446, P = 0.488, respectively). Sensitivity was notably higher when patch readings were conducted 72 h after application compared to 48 h [0.95 (CI: 0.91-0.97) vs. 0.60 (CI: 0.55-0.66)]. Patch testing is imperative for suspected cases of allergic contact dermatitis in all children, regardless of their atopic background. Further research is warranted to potentially replace the traditional 48-h reading with a single 72-h reading in future guidelines, contributing to enhanced efficiency and cost-effectiveness in clinical practice.

Contact allergy caused by acrylates in nail cosmetics: A pilot study from Greece.

The growing popularity of nail techniques based on acrylates has led to a higher frequency of sensitization in both nail technicians and users. The study aimed to assess cases of allergic contact dermatitis (ACD) caused by acrylates in individuals with occupational or non-occupational exposure to nail techniques. A preliminary study was conducted on 30 patients with ACD caused by acrylates in nail techniques, who were patch tested from September 2022 to March 2023 at the First Department of Dermatology and Venereology of Andreas Syggros Hospital, Athens, Greece. Thirty female patients with ACD to acrylates were documented (15 users and 15 nail technicians and users). The most common allergens were: 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA) and ethyleneglycol dimethacrylate (EGDMA), which tested positive in all 30 patients (100.0%). Twenty patients (66.7%) had been exposed to dental procedures involving acrylates, before the onset of ACD. Nail technicians exhibited extensive skin lesions, 40.0% experienced ACD within the first year of work and 13.3% during their professional practice. Three of them (20.0%) had to discontinue their work. Acrylates have been identified as potent allergens, necessitating the implementation of safety measures for the use of these chemicals in nail techniques.

Botanical Briefs: Contact Dermatitis Induced by Western Poison Ivy (Toxicodendron rydbergii).

"Leaves of three, leave it be" serves as an apt caution for avoiding poison ivy (Toxicodendron species) and its dermatitis-inducing sap. Toxicodendron contact dermatitis (TCD) poses a notable burden to the American health care system by accounting for half a million reported cases of allergic contact dermatitis (ACD) annually. Identifying and avoiding physical contact with the western poison ivy (Toxicodendron rydbergii) plant prevails as the chief method of preventing TCD. This article discusses common features of T rydbergii as well as clinical manifestations and treatment options following exposure to this allergenic plant.

Issues of pathogenesis and treatment of contact dermatitis in children of the first year of life

The article presents the pathogenetic features of dermatitis in children of the first year of life, features of the clinical picture and approaches to therapy. Contact dermatitis is a fairly common pathology in young children. Previously, it was believed that the clinical manifestations in this group of children were mainly associated with simple contact dermatitis (SCD), but in recent years, studies have shown that contact sensibilization is quite common, and currently the diagnosis of allergic contact dermatitis (ACD) is not uncommon, but timely anti-inflammatory therapy prevents the formation of a focus of chronic inflammation. The prevalence of SCD and ACD in children of the first year of life, as well as the severity of skin inflammation, is associated with the existing structural features of the skin. Changes in the structures of the epidermis and dermis, characteristic of this age period, lead to easier skin damage when exposed to various irritants, both mechanical and chemical in nature, and the penetration of allergens into the skin. The peculiarity of the structure of blood vessels and increased vascular permeability is an important factor in the development and longer existence of local inflammation. The main condition for the effectiveness of treatment of dermatitis is the cessation of exposure to the substances that caused their development, and the main means of treating these conditions are topical glucocorticosteroids (TGCS). The article discusses cases of SCD and ACD in children of the first year of life, in which methylprednisolone aceponate in the form of 0.1% cream was used for external therapy. The choice in favor of this TGCS was made due to the absence of halogens in the methylprednisolone aceponate formula, the possibility of use from 4 months of age and in sensitive areas. During treatment, all patients had a good clinical effect and no side effects. The use of methylprednisolone aceponate in the form of 0.1% cream for SCD and ACD in children of the first year of life is a highly effective and safe remedy.

A Case of Allergic Reaction to 0.5% Moxifloxacin Eye Drops

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment.Conclusions: Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

ALLERGIC CONTACT DERMATITIS WITH AN UNUSUAL CONFIGURATION AFTER PREOPERATIVE POVIDONE-IODINE DISINFECTION. A CLINICAL CASE

Contact dermatitis is an inflammatory skin reaction resulting from skin contact with exogenous substances that act as allergens and/or irritants. Epicutaneous testing is the gold standard for diagnosing allergic contact dermatitis and differentiating it from irritant contact dermatitis. We present a clinical case of allergic contact dermatitis after preoperative povidone-iodine disinfection.

Honey flower dermatitis: Contact allergy to ellagic acid in Melianthuscomosus.

A case study is reported whereby a patient with no prior allergies developed a strong and spreading delayed-type hypersensitivity reaction to Melianthus plants, nectar and synthetic pigment derived from it after frequent handling of these substances. The lesions improved after treatment with topical steroids and allergen avoidance within 1-2 weeks. Subsequent patch testing with the plants, nectar and synthetic ingredients identified ellagic acid (EA) as the sensitizing agent. This is the first proven case of allergic contact dermatitis to EA, a phenolic substance present in numerous plants, fruits, and nuts regularly consumed by humans. Melianthus use is growing worldwide as an ornamental plant. Moreover, it is used in traditional South African medicine for its anti-inflammatory effects. In recent years, these extracts and EA have been added to natural, plant-based topical formulations for the treatment of inflammatory skin disorders. Our observation that the EA found in Melianthus can induce severe contact allergy should caution for the possible dangers of specific allergic sensitizations to these increasingly used additives in natural medicines.

Self-Reported Allergic Occupational Contact Dermatitis among Dental Healthcare Professionals in United Arab Emirates -A Cross Sectional Study.

In dentistry, occupational contact dermatitis may affect dental professionals along with technicians, nurses, and patients. Changes to dental practice in recent years have altered the reported frequencies of allergens causing contact dermatitis in both dental professionals and dental patients. In the current cross-sectional study, we used a structured questionnaire and clinical examinations to examine the prevalence of self-reported hand eczema among United Arab Emirates (UAE). The relationship between subjective skin discomfort and latex, composite/bonding, or other dental materials also was explored. A structured questionnaire was designed to analyze the prevalence of skin conditions among dental professionals and study its implication in gender, occupation, and age groups. The questionnaire included information about skin symptoms, atopy, occupational experience, and other background factors like respiratory symptoms, work history and methods, and exposure at work. It was distributed to 550 randomly selected dental healthcare professionals. Out of 550 dental healthcare workers contacted, 434 responded giving a response rate of 79%. The prevalence of dry and rough skin on the hands was highest (45%). There was a total of 29 cases of allergic contact dermatitis, 15 cases of contact urticaria, 12 cases of irritating contact dermatitis, and 1 incidence of onychomycosis among the 100 dental healthcare professionals who reported having dermatitis on their hands, forearms, or faces due to their daily dental chores. Rubber chemicals and natural rubber latex (NRL) in protective gloves used by dentists, as well as dental-restorative plastic materials (methylacrylates), were the most common causes of allergy. Dry skin and hand eczema were more common among dental healthcare professionals. Plastic gloves or NRL gloves with a low protein content are recommended for dental work. Skin exposure to methylacrylates or latex should be avoided.

CD06 Delving in to Disperse Orange 1

Abstract Disperse Orange 1, colour index 11080, is an azo dye. Collectively, azo dyes are a common cause of textile-related allergic contact dermatitis (ACD). A 2006 European Union (EU) directive restricts the sale of any articles or dyed items that have direct and prolonged contact with the skin or the oral cavity and contain more than 30-ppm azo dyes. These include a wide range of items such clothing, bedding, furniture, toys and yarn. Despite clear regulation set out by the directive, these dyes have been detected within garments produced and sold within the EU (https://echa.europa.eu/regulations/reach/legislation). In our cutaneous allergy clinic, we have patch tested a total of 547 patients to the clothing and dye series. Only seven (1.3%) have tested positive to Disperse Orange 1. We present a series of cases and highlight the suspected sources of exposure. We identified a total of seven patients, four of whom were male. Their ages ranged between 20 and 78 years. Aside from Disperse Orange 1, all patients developed positive patch test results to other disperse dyes. Three patients also reacted to paraphenylenediamine. Sites affected included the head and neck (n = 4), hands (n = 2), chest (n = 1) and leg (n = 1). Other series patients tested positive to included fragrances, metals, rubber, acrylates and local anaesthetics. Suspected sources of Disperse Orange 1 included hair dyes, clothing, wound dressings and a thyroid shield. Few cases of ACD have been published on Disperse Orange 1. One report noted a textile necklace as a source of a severe localized ACD (Nygaard U, Kralund HH, Sommerlund M. Allergic contact dermatitis induced by textile necklace. Case Rep Dermatol 2013; 5:336–9). We wish to raise awareness of the presence of problems with Disperse Orange 1, despite the EU directive. Members should consider a variety of sources, including traditional items such as clothing and hair dyes and also newer items such as dressings and thyroid shields, as suspected in our cases.

Allergic contact dermatitis in pediatric practice.

Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and quality-of-life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD. We have, in this paper, provided an overview of ACD and discussed common and unusual causes of ACD. We performed an up-to-date literature review in the English language on "allergic contact dermatitis" via PubMed Clinical Queries, using the keywords "allergic contact dermatitis" in August 2022. The search included meta-analyses, randomized controlled trials, clinical trials, case-control studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children. ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of immunotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains unknown. ACD is common and can be a physically, psychologically, and economically burdensome disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physical examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or high-potency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.

Allergic contact dermatitis from propylene glycol: A case series from Australia.

Propylene glycol (PG) is used in a variety of cosmetics, food and pharmaceuticals. PG is a known sensitizer but also irritating when patch tested (PT). The aims were to investigate the frequency of contact sensitization to PG and to identify cases of allergic contact dermatitis (ACD). A retrospective study was performed on patients PT at the Skin Health Institute (SHI), Victoria, Australia to PG 5% pet. and PG 10% aq. between 1 January 2005 and 31 December 2020. In all, 6761 patients were PT to PG and 21 (0.31%) reacted. Of those 21 individuals, 9 (42.9%) had a relevant reaction. 75% of relevant positive reactions were in patients PT to PG 10% aq. The most common source of PG exposure was topical medicaments (77.8% of relevant reactions) and moisturizers, with the largest group being topical corticosteroids. Contact sensitization to PG in the patch test population remains uncommon, although it is possible that testing with concentrations of 5%-10% PG did not identify all reactions. Topical corticosteroids were the most important cause. Patients with suspected contact dermatitis to topical corticosteroids should be PT to PG.

Sofa dermatitis: Value of patch test with 2-(thiocyanomethylthio)benzothiazole.

In 2008, numerous cases of allergic contact dermatitis caused by leather chairs (sofa dermatitis) were reported, with dimethylfumarate being the culprit allergen. However, octylisothiazolinone, methylisothiazolinone and cobalt have also been associated with cases of sofa dermatitis. An antifungal agent, 2-(thiocyanomethylthio)benzothiazole (TCMTB), has also previously been described as a contact allergen in leather. Seven patients were referred to the Department of Dermatology of the Cliniques universitaires Saint-Luc, Brussels, Belgium with suspicion of allergic contact dermatitis caused by leather sofas. They were patch tested with the European Baseline Series, additional series (according to the patients' history and clinical aspect of the eruption), dimethylfumarate (4/7 patients) and with TCMTB. All seven patients presented a positive reaction to TCMTB and only one presented a concomitant positive reaction to dimethylfumarate. All patients showed clinical improvement after avoiding contact with their leather sofa. 2-(Thiocyanomethylthio)benzothiazole (TCMTB) is probably an underestimated allergen present in leather chairs (responsible for the so-called 'sofa dermatitis'), and more generally in leather objects. It is, therefore, important to test with TCMTB 0.1% petrolatum in case of contact dermatitis related with leather products.

Tobramycin and antiglaucoma agents as increasing culprits of periorbital allergic contact dermatitis from topical ophthalmic medications: A 24-year study from Turkey.

Allergic contact dermatitis (ACD) from topical ophthalmic medications (TOMs) poses an additional disease burden to patients who already suffer from eye problems. To investigate the epidemiological/clinical profile of patients with periorbital ACD from TOMs in Turkey. This was a retrospective, cross-sectional, single tertiary centre study based on files of 75 patch tested patients with suspected periorbital ACD from TOMs among a total of 2801 consecutively patch tested patients with suspected ACD of any origin between 1996 and 2019. Periorbital ACD was diagnosed in 25 of 75 (33.3%) patients (female:male=1.8:1; age range: 6-85 years) with suspected ACD from TOMs showing an overall prevalence of 0.9% (25/2801) among the whole patch test population. Atopy was not present. Tobramycin-containing TOMs were the most frequent culprits, followed by antiglaucoma preparations. Their frequency increased, whereas no new cases of neomycin-induced ACD were observed after 2011. Positivities with thimerosal were of unknown clinical relevance, while benzalkonium chloride (BAC) caused ACD in two patients. The diagnosis would be missed in each 20% of patients without performing day (D) 4 and D7 readings and strip-patch testing. Ten culprits were identified only by testing with patients' own TOMs in eight (32%) patients. Aminoglycosides, particularly tobramycin, were the leading cause of ACD from TOMs. The frequency of ACD from tobramycin and antiglaucoma medications increased after 2011. BAC was a rare but important allergen. Additional D4 and D7 readings, strip-patch testing, and testing with patients' own TOMs seem essential when patch testing with eye medications.

Retrospective quantitative risk assessment of skin sensitization caused by an antimicrobial agent used in a consumer product: 2,3,5,6-Tetrachloro-4-(methylsulfonyl) pyridine.

Serious cases of allergic contact dermatitis (ACD) caused by exposure to 3,5,6-tetrachloro-4-(methylsulfonyl)pyridine (TCMSP; CAS no. 13108-52-6) used as an antimicrobial agent for desk mats have been reported in Japan. A quantitative risk assessment (QRA) of TCMSP contained in desk mats was performed retrospectively. A local lymph node assay (LLNA): BrdU-ELISA was conducted to determine a reliable EC1.6 value for TCMSP. The acceptable exposure level (AEL) for TCMSP was derived from the EC1.6 value by applying sensitization assessment factors (SAFs). The exposure level was estimated based on the assumption referring to the use conditions of thiabendazole in the same purpose. Then, the estimated exposure level was compared with the AEL to evaluate the skin sensitization risk. The AEL was calculated as 0.00458 μg/cm2 based on the EC1.6 value (0.011%, 2.75 μg/cm2 ) by applying a composite SAF of 600. The estimated TCMSP exposure level from the desk mat was 500 times greater than the AEL, indicating a serious skin sensitization risk. Assessments of skin sensitization potencies of chemicals to be used in consumer products are strongly recommended, and QRAs should be performed at the pre-marketing stage to avoid the skin sensitization risk in consumers.

Allergic Contact Dermatitis: Sensitization to 2-Hydroxyethyl Methacrylate

Acrylate polymers are an important cause of allergic contact dermatitis. Over the last decades, the vector of allergy to methacrylic acid esters has shifted from industrial products to the beauty and medical industries. In the described clinical case, the potential risk of sensitization to 2-hydroxyethyl methacrylate, a component of medical products, is emphasized, particularly in patients working in the cosmetology field. The authors present a clinical case of allergic contact dermatitis caused by 2-hydroxyethyl methacrylate, a component of the adhesive in a medical plaster. Basic diagnostic measures, including allergodiagnostics using a patch test, were conducted. Based on the collected data, the diagnosis was verified, and therapy for allergic contact dermatitis was prescribed according to the international clinical treatment protocol. The increasing number of cases of allergic contact dermatitis caused by acrylate compounds in medical materials requires further investigation and the implementation of effective preventive measures to ensure patient safety.

Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies.

The potential for many of the commonly used surgical site wound adhesives, skin antiseptic solutions, topical antibiotics, and suture materials to sensitize and subsequently result in allergic contact dermatitis (ACD) has become increasingly recognized within orthopedic surgery. Particularly with subsequent exposure to the offending allergen, the cutaneous allergic reaction may present in a similar fashion to cellulitis, thus making early differentiation between the two etiologies to initiate the appropriate and timely treatment crucial. Recognition of the characteristic appearance and severity of ACD surrounding a surgical wound often drives the initial management. This typically consists of anti-histamines, topical corticosteroids, and possible removal of the offending allergen for low grade findings and oral steroids and prophylactic oral antibiotics for the more severe reactions. Multidisciplinary care, including the expertise of a dermatologist or wound care specialist when faced with this challenging clinical scenario is critical and elective patch testing may be indicated to ascertain the exact allergen involved, particularly in patients with a prior history of wound issues. Finally, any clinical cases of ACD following an orthopedic procedure should be documented in the patient's chart so that exposure can be avoided with any future surgery.

Clinico-Epidemiological Profile of Allergic Contact Dermatitis and Its Correlation With Patch Testing in a Tertiary Care Center in Eastern India.

Allergic contact dermatitis (ACD) is one of the most commonskin disorders seen among patients attending dermatology clinics in India. Patch testing is the gold standard for diagnosing ACD. The clinical-epidemiological pattern of ACD and the allergen-causing it may be different in different geographic locations. Finding the profile of allergens commonly causing ACD in a particular region will help to formulate prevention strategies for the development of ACD. The primary aim of the study was to find out the clinical-epidemiological distribution of allergic contact dermatitis and to identify the common allergens causing it by patch testing in this region of India. A total of 111 cases of ACD were included in the study. Clinico epidemiological profiles of all patients were documented. The patch testing was performed in the outpatient department using the antigens of the Indian Standard Series kit (Systopic Laboratories Pvt. Ltd., New Delhi, India). Patches were removed after 48 hours (two days) of application. The first reading was taken 15 to 20 minutes after the removal of patches on day two.A second reading was taken on day four (96 hours of application) to confirm the presence of an allergic reaction. Results: The patch test was found to be positive in 69% of cases. It was observed that male persons from lower socioeconomic status were getting ACD on most accounts. Potassium dichromate (PDC) was found to be the most commonallergen (30.43%) followed by parthenium (26.08%), para-phenylenediamine (PPD) (21.73%), nickel sulfate (18.84%), chlorocresol (15.94%), black rubber (14.49%), cobalt sulfate (13.04%), and wool alcohols (7.24%) respectively. Our study showed potassium dichromate is the commonest allergen causing ACD in this part of the country. The importance of patch testing lies mainly in educating the patient regarding the avoidance of exposure to particular allergens to avoid the development of new ACD as well as an exaggeration of pre-existing ACD.

2-Octyl cyanoacrylate, a hidden allergen, a common cause of postsurgical allergic contact dermatitis.

Background: 2-Octyl cyanoacrylate, a topical adhesive used for wound closure, is becoming a common cause for rashes in postsurgical patients. There is an increased number of cases of postsurgical contact dermatitis attributable to 2-octyl cyanoacrylate. Localized skin reactions to 2-octyl cyanoacrylate have been described in different case reports, but there are limited case reports of diffuse cutaneous allergic reactions. Objective: The aim of the study was to review our experience in patch testing with cyanoacrylates. Methods: We reported five cases of allergic contact dermatitis to 2-octyl cyanoacrylate, confirmed by a patch test. All the patients experienced a skin reaction a few days after surgery. The patients described an erythematous pruritic rash initially localized over the incision and that subsequently spread to surrounding areas. Two of the five patients developed a more widespread rash, which required a longer duration of systemic steroids. 2-Octyl cyanoacrylate remains an agent of low diagnostic suspicion as the possible cause of contact dermatitis after a surgical procedure. Results: All the patients, but one had a positive reaction to 2-octyl cyanoacrylate on PT. Four had a positive PT result, with one patient having a positive scratch test after a negative PT result. Testing on abraded skin further increased yield. Conclusion: Postsurgical patients should be evaluated by using a patch test if there is a clinical picture suggestive of contact dermatitis.