000139 - Allergic contact dermatitis due to acrylates in catheter fixation devices

Acrylates are synthetic polymers whose use has increased markedly since the 19th century. They are widely employed in industry, cosmetics, and medicine. This broad use has led to an increase in allergic contact dermatitis (ACD) related to acrylates, particularly in cosmetics and medical devices.

The use of adhesive dressings has expanded in minimally invasive procedures, trauma care, and catheter fixation to prevent displacement. Some of these devices contain acrylates, which may induce sensitization or elicit reactions in previously sensitized individuals.

A 50-year-old woman with a history of adhesiolysis and ileostomy, and exocrine pancreatic insufficiency with malabsorption syndrome and steatorrhea, has been receiving parenteral nutrition since September 2018. She was referred to the allergy department due to recurrent eczematous and occasionally vesicular lesions following the use of Derma-flex® dressings after surgical procedures, as well as after application of a StatLock® catheter fixation device for a centrally inserted catheter.

Patch testing was performed using:

·  Martí Tor acrylate battery

·  Suspected and alternative adhesive materials

·  The Martí Tor acrylate battery showed positive reactions at 48 and 96 hours to cyanoacrylates.

·  Patch testing with suspected and alternative adhesives (1: Tegaderm®, 2: Derma-flex®, 3: StatLock®, 4: Tegaderm® central area, 5: Tegaderm® lateral area, 6: Opsite®) was positive at 48 and 96 hours for Derma-flex® and StatLock® (Figure 1).

Devices using StatLock® technology and tissue adhesives have significantly reduced catheter displacement and related complications, leading to their widespread use. However, allergic sensitization to the acrylates contained in these devices represents an emerging challenge for allergists. Comprehensive patch testing with acrylate-specific batteries is essential to ensure accurate diagnosis and to guide appropriate patient management. Correct identification of the responsible allergen allows the selection of safe alternative catheter fixation options.Furthermore, establishing an accurate diagnosis is essential for offering safe alternative attachment options for catheters.