Patch testing identifies relevant allergens in suspected diabetes-device dermatitis

A retrospective study of 100 patients referred for suspected allergic contact dermatitis from diabetes devices assessed a dedicated screening series alongside other patch tests. The screening series found at least one clinically relevant reaction in 50 patients, while testing patients’ own device adhesives or extracts sometimes detected reactions missed by the series alone.

Study included 100 patients referred for suspected device-related dermatitis.
Screening-series reactions were clinically relevant in 50 patients.
Patient-specific adhesive testing sometimes detected additional reactions.
The retrospective study was conducted at a tertiary referral centre.

This retrospective patch-test study included 100 patients at a tertiary referral centre with suspected allergic contact dermatitis linked to glucose sensors, insulin patch pumps or infusion sets. Investigators evaluated a dedicated diabetes-device screening series, supplemented by a (meth)acrylate series and testing of patients’ own device adhesives and adhesive extracts.

Seventy-one patients reacted to one or more allergens in the screening series; at least one reaction was considered clinically relevant in 50 of those patients (70.4%). Frequently relevant allergens included colophonium and related substances, isobornyl acrylate, dicyclohexylmethane-4,4′-diisocyanate and N,N-dimethylacrylamide. The (meth)acrylate series provided no clear additional diagnostic value. Testing patients’ own adhesives and extracts often identified reactions to devices not detected by the screening series alone.

The findings support a combined testing approach when allergic contact dermatitis from diabetes devices is suspected, particularly because device composition and relevant allergens may be unclear. The study was retrospective and conducted at a tertiary referral centre; its results do not establish performance in other settings or show that testing improves clinical outcomes.

In practice

For patients with suspected allergic contact dermatitis related to glucose sensors, insulin patch pumps or infusion sets, a dedicated diabetes-device patch-test series identified clinically relevant reactions in 50 of 100 referred patients. Testing the patient’s own device adhesives or extracts may reveal reactions not identified by the screening series alone. These findings support considering both approaches in diagnostic evaluation, but evidence is from a retrospective study at one tertiary referral centre and does not establish improved patient outcomes or generalizability to other settings.

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Source

Contact Dermatitis: High Diagnostic Yield of Testing With a Diabetes Device Screening Series in Patients With Suspected Allergic Reactions to Glucose Sensors, Insulin Patch Pumps and Insulin Infusion Sets ↗

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