Medical Adhesive Allergens: Retrospective Analysis of Cross-Sectional Data from the North American Contact Dermatitis Group, 2001-2018

The Incidence and Risk Factors for Medical Adhesive-Related Skin Injury in Cancer Patients in China: A Systematic Review and Meta-Analysis

To explore the incidence and risk factors for medical adhesive-related skin injury (MARSI) in cancer patients in China, and to provide a basic framework for approaches designed to reduce the occurrence of MARSI and improve the management of its risk factors. PubMed, Web of Science, The Cochrane Library, EmBase, CNKI, VIP, Wanfang, and CBM were searched from database inception to October 2024. The Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used to assess the quality of the included studies, and a random-effects model with Stata 15.0 software was utilized for calculating the pooled incidence and risk factor for MARSI in cancer patients. A total of 18 studies were included, with 11,393 patients. Meta-analysis showed that the pooled incidence of MARSI in Chinese cancer patients was 24%. In subgroup analyses, dermatitis demonstrated the highest incidence rate (10%). MARSI history, allergy history, dressing type (3M), puncture site (upper arm), gender (female), BMI > 25 kg/m2, moist skin, and age (≥ 50 years) were risk factors for MARSI in cancer patients. The incidence of MARSI in Chinese cancer patients is high, and MARSI history, allergy history, dressing type (3M), puncture site, gender (female), BMI > 25 kg/m2, moist skin, and age (≥ 50 years) were risk factors for the occurrence of MARSI in Chinese cancer patients, suggesting that early identification and protection of high-risk patients, and timely targeted preventive measures are important to reduce the incidence of MARSI in cancer patients.

Prospective evaluation of hospital-acquired skin lesions in dogs: A case-control study

BACKGROUND

Hospital-related dermatological conditions are well-studied and reported in human medicine. However, studies about these dermatological disorders in veterinary medicine are lacking.

OBJECTIVES

To report the incidence, type and distribution of hospital-acquired skin lesions (HASL) in dogs, and to investigate risk factors that may be associated with their development.

ANIMALS

Hospitalised client-owned dogs with HASL and a control group of hospitalised dogs without skin lesions.

MATERIALS AND METHODS

Prospective clinical evaluation of all HASL and dermatological tests, when indicated, were performed, over 6 months. A variety of potentially predisposing factors also were recorded.

RESULTS

Thirty-one dogs with HASL and a matched control group of 60 hospitalised dogs without skin lesions were included. The incidence of HASL was 11.2% (31 of 278). The most common lesion was erythema in 74.2% of dogs (23 of 31) and the most affected area was the abdomen in 58.1% (18 of 31) of dogs. Faecal and/or urinary incontinence was identified as an important risk factor for the development of skin lesions during hospitalisation (odds ratio 14.445, 95% confidence interval 1.444-144.479, p = 0.023). Immobilisation and changes in body temperature also may play a role in the development of such lesions in dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

Faecal and/or urinary incontinence was found to be an important factor in the development of HASL. The impact of HASL on patient outcomes and the prevention of these lesions requires further investigation.

Colophonium-related Allergic Contact Dermatitis Caused by Medical Adhesive Tape Used to Prevent Skin Lesions in Soldiers

Medical adhesive tapes are commonly recommended for the prevention of friction blisters during hiking and military marches. The aim of this paper is to report on the results of investigations into an outbreak of tape-related foot dermatitis in 26 military conscripts following continuous use of medical adhesive tapes for several days during a field exercise. Patch tests were performed using baseline series and aimed testing was performed with colophonium-related substances and different medical adhesive tapes. Contact allergy to the adhesive tapes used was found in 20 (77%) subjects, and contact allergy to colophonium in 16 (61%). Chemical analysis detected colophonium-related substances in the culprit tapes. Compared with consecutive dermatitis patients investigated at our Department of Occupational and Environmental Dermatology in the previous 10 years, conscripts with colophonium allergy had increased odds ratios for concomitant contact allergy to phenol formaldehyde resins and fragrance substances including hydroperoxides of limonene and linalool. The results show that prolonged use of medical adhesive tapes on intact skin carries a high risk for allergic contact dermatitis. Prior to their introduction on the market, medical devices should be assessed for possible side-effects.

2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis-Part 1. Introduction, epidemiology, case series and case reports

2-Hydroxyethyl methacrylate (HEMA) has been increasingly recognised as a contact allergen and was added to the European baseline series in 2019. In this article (2 parts), the results of an extensive literature review of the clinical aspects of contact allergy/allergic contact dermatitis to HEMA are presented. In part 1, the epidemiology of HEMA contact allergy is discussed and detailed information on published case series and case reports presented. HEMA is an important cause of contact allergy/allergic contact dermatitis in North America and Europe with recent prevalences of >3% in the USA + Canada and 1.5%-3.7% in Europe. Currently, most cases are caused by nail cosmetics, both in consumers and professional nail stylists. In our literature review, we have found 24 studies presenting case series of patients with allergic contact dermatitis attributed to HEMA and 168 case reports. However, the presence of HEMA in the products causing ACD was established in only a minority. Part 2 will discuss cross- and co-sensitisation, and other skin reactions to HEMA, will assess whether HEMA is the most frequent (meth)acrylate allergen and how sensitive HEMA as a screening agent is, investigate the presence of HEMA in commercial products and provide practical information on patch testing procedures.

Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case-control study

BACKGROUND

As both allergic contact dermatitis and atopic dermatitis (AD) have similar clinical presentations and are characterized by spongiotic dermatitis on skin biopsy, many children with AD are not referred for patch testing and allergic contact dermatitis is underdiagnosed.

OBJECTIVE

To provide updated prevalence data of common contact allergens in children with and without AD.

METHODS

This is a retrospective case-control study using the Pediatric Allergic Contact Dermatitis Registry from 2018 to 2022.

RESULTS

A total of 912 children were included (615 with AD and 297 without AD). Children with AD were more likely to have a longer history of dermatitis (4.1 vs 1.6 years, P < .0001), have seen more providers (2.3 vs 2.1, P = .003), have greater than 1 positive patch test (PPT) result (P = .005), have a greater number of PPT results overall (2.3 vs 1.9, P = .012), and have a more generalized distribution of dermatitis (P = .001). PPT to bacitracin (P = .030), carba mix (P = .025), and cocamidopropyl betaine (P = .0007) were significantly increased in children with AD compared to those without AD.

LIMITATIONS

Technical variation between providers and potential for misclassification, selection, and recall biases.

CONCLUSION

Children with AD are significantly more likely to have PPT reactions and should be referred for evaluation of allergic contact dermatitis and obtain patch testing.

Documented Contact Allergy Impacts Risk for Surgical Adhesive-Associated Contact Dermatitis after Shoulder Arthroplasty

Purpose

The purpose of this study is to report on the incidence and risk factors for allergic contact dermatitis (ACD) in patients who received Prineo after total shoulder arthroplasty (SA).

Methods

A retrospective case-control study was conducted to investigate patients who experienced ACD after having SA by a single surgeon during a defined period when Prineo was routinely used as an adjunct to wound closure. Known risk factors for ACD (e.g., history of contact dermatitis, smoking) were analyzed for association development of Prineo-associated ACD using Fisher exact and Wilcoxon rank sum tests.

Results

From June 2019 through July 2021, 236 consecutive patients were identified as having Prineo applied after SA. Nine cases of Prineo-ACD (3.8%) were documented, whereas 227 patients were unaffected. In all 9 affected patients, the complication was identified and treated without compromising the outcome of the SA. Previous allergy to medical adhesives was a statistically significant risk factor for Prineo-associated ACD in this series (P = .01). The odds of having Prineo-associated ACD among those with adhesive or contact allergy was 38.5 times that of their nonallergic counterparts in a multivariate model.

Conclusions

Prineo adhesive ACD had an incidence of 3.8% in this study, and a history of adhesive or contact allergy was highly associated with its development.

Level of Evidence

Level III, case-control study.