Anne Herman1, Olivier Aerts2, Marie Baeck1, Magnus Bruze3, Christophe De Block4, An Goossens5, Nils Hamnerius3, Sara Huygens5, Dominique Maiter6, Dominique Tennstedt1, Bernard Vandeleene6, Martin Mowitz3. 1. Department of Dermatology, Cliniques Universitaires Saint-Luc, 1200, Brussels, Belgium. 2. Department of Dermatology, University Hospital Antwerp and University of Antwerp, 2650, Antwerp, Belgium. 3. Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden. 4. Department of Endocrinology-Diabetology-Metabolism, University Hospital Antwerp (UZA) and University of Antwerp (UA), 2650, Antwerp, Belgium. 5. Department of Dermatology, University Hospitals, KU Leuven, 3000, Leuven, Belgium. 6. Department of Endocrinology, Cliniques Universitaires Saint-Luc, 1200, Brussels, Belgium.
Abstract
BACKGROUND: Glucose sensors, such as FreeStyle® Libre, are innovative medical devices developed for diabetes patients as a replacement for classic glucose meters, ensuring continuous glucose monitoring without the disadvantage of regular skin finger pricks. OBJECTIVES: To report several cases of allergic contact dermatitis caused by FreeStyle® Libre, and to report on isobornyl acrylate as a culprit allergen. PATIENTS AND METHODS: Fifteen patients presented with allergic contact dermatitis caused by FreeStyle® Libre. All but 1 were patch tested with a baseline series, and with pieces and/or ultrasonic bath extracts of (the adhesive part of) the glucose sensor. Isobornyl acrylate was patch tested, in various concentrations and vehicles, in 13 patients. Gas chromatography-mass spectrometry (GC-MS) of the sensors was performed. RESULTS: All patients reacted to the adhesive part of the sensor, and 12 patients were shown to be sensitized to isobornyl acrylate. Simultaneous reactions to other allergens were rarely observed. GC-MS showed the presence of isobornyl acrylate in the sensors. CONCLUSIONS: Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.
BACKGROUND:Glucose sensors, such as FreeStyle® Libre, are innovative medical devices developed for diabetespatients as a replacement for classic glucose meters, ensuring continuous glucose monitoring without the disadvantage of regular skin finger pricks. OBJECTIVES: To report several cases of allergic contact dermatitis caused by FreeStyle® Libre, and to report on isobornyl acrylate as a culprit allergen. PATIENTS AND METHODS: Fifteen patients presented with allergic contact dermatitis caused by FreeStyle® Libre. All but 1 were patch tested with a baseline series, and with pieces and/or ultrasonic bath extracts of (the adhesive part of) the glucose sensor. Isobornyl acrylate was patch tested, in various concentrations and vehicles, in 13 patients. Gas chromatography-mass spectrometry (GC-MS) of the sensors was performed. RESULTS: All patients reacted to the adhesive part of the sensor, and 12 patients were shown to be sensitized to isobornyl acrylate. Simultaneous reactions to other allergens were rarely observed. GC-MS showed the presence of isobornyl acrylate in the sensors. CONCLUSIONS: Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.
Authors: Rachel S Rigo; Laura E Levin; Donald V Belsito; Maria C Garzon; Rachelle Gandica; Kristen M Williams Journal: J Diabetes Sci Technol Date: 2020-05-09