Journal
DERMATITIS
Volume 31, Issue 1, Pages 4-12Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/DER.0000000000000549
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Multidisciplinary collaboration between several European dermatology departments has identified isobornyl acrylate (IBOA; CAS 5888-33-5), once deemed a low-risk sensitizer, as a major culprit contact allergen in glucose sensors and insulin pumps, medical devices used by diabetes patients worldwide. Although the patch test modalities of IBOA have been fairly well characterized, intriguing questions remain. For example, its cross-reactive profile to other acrylates remains to be determined, and the striking occurrence of concomitant positive patch test reactions to sesquiterpene lactones needs to be further elucidated. Importantly, the path to its discovery as a contact sensitizer in diabetes devices and the difficulties that were associated with this quest illustrate that apparent difficulties in obtaining sufficient cooperation from the medical device industry may seriously hamper the correct workup of cases of allergic contact dermatitis. The IBOA saga will convince companies to lend more cooperation to dermatologists and policymakers to side with patients and physicians when it comes to updating medical device regulations, including the compulsory labeling of medical devices in general and of diabetes devices in particular.
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