001493 - Allergic contact dermatitis due to acrylates contained in catheter fixation devices catheters

Acrylates are synthetic polymers whose utilization has notably increased since the 19th century. They are employed across various sectors, including industry, cosmetics, and medicine. This versatility has led to a rise in their allergenic potential and an increase in research on allergic contact dermatitis (ACD) linked to acrylates in cosmetics and medical devices.

The use of adhesive bandages has grown, particularly for minimally invasive surgeries and trauma-related lacerations, as well as for catheter fixation to prevent displacement. Some of these dressings or devices contain acrylates, which may sensitize or provoke reactions in individuals with prior acrylate sensitivities.

A 50-year-old patient with a medical history encompassing adhesiolysis and ileostomy, coupled with exocrine pancreatic insufficiency resulting in malabsorption syndrome and steatorrhea, has been reliant on parenteral nutrition since September 2018. She was referred to allergy specialists due to the emergence of eczematous and occasionally vesicular lesions associated with Derma-Flex dressings following surgical interventions, as well as the application of a Stat-lock fixation device for a centrally inserted catheter. Epicutaneous testing was conducted utilizing:- Marti Tor acrylate battery.- Identified and alternative adhesive materials.

- Marti Tor acrylate battery: exhibited a positive response after 48 and 96 hours specifically for cyanoacrylates.- Identified and alternative adhesives: 1: Tegaderm, 2- Derma-flex, 3- Stat-lock, 4- Tegaderm (central region), 5- Tegaderm (lateral region), 6- Opsite adhesive. Positive results were documented at both the 48 and 96-hour marks for Derma-flex and Stat-lock.

Devices employing stat-lock technology and tissue adhesives have significantly diminished catheter displacement, thereby mitigating associated complications. Consequently, their prevalence has increased, and the potential for allergic sensitization to the acrylates they contain presents a new challenge for allergists. It is imperative that comprehensive investigations utilizing epicutaneous batteries specific to acrylates be conducted to enhance diagnostic accuracy and facilitate appropriate patient recommendations. Furthermore, establishing an accurate diagnosis is essential for offering safe alternative attachment options for catheters.