Contact Dermatitis to Diabetes Medical Devices

Abstract

Skin adverse reactions to diabetes medical devices have been reported frequently over recent years. Adhesives attaching glucose sensors and continuous insulin infusion sets to the skin are proven to cause both allergic contact dermatitis and irritant contact dermatitis in patients with diabetes mellitus. Several allergens contained in adhesives and/or parts of medical devices are documented to cause allergic contact dermatitis, with acrylate chemicals being the most common culprit-especially isobornyl acrylate (IBOA), but also 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate or cyanoacrylates. Epoxy resin, colophonium and nickel were also identified as causative allergens. However, repetitive occlusion, maceration of the skin and resulting disruption of the skin barrier seem to have an impact on the development of skin lesions as well. The purpose of this study is to highlight the burden of contact dermatitis triggered by diabetes medical devices and to show possible mechanisms responsible for the development of contact dermatitis in a group of diabetic patients.

Keywords: 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate; IBOA; MBPA; allergic contact dermatitis; diabetes medical devices; glucose sensors; insulin pumps; irritant contact dermatitis; isobornyl acrylate.

Figure 1

Factors contributing to the development of contact dermatitis from diabetes medical devices.