Colophony is Most Common Medical Adhesive Allergen in ACD

Colophony is the most common allergen in patients with a medical adhesive source of contact allergy and allergic contact dermatitis (ACD), according to a study published in the Journal of the American Academy of Dermatology.

Researchers evaluated the demographics, clinical characteristics, patch test results, and occupational data for patients in the North American Contact Dermatitis Group (NACDG) with medical adhesive contact allergy. A total of 43,722 patients were patch tested from 2001 to 2018.

Eligible participants had a medical adhesive (tapes/adhesive aids/suture glue) documented as the source of a positive patch test reaction to either an NACDG screening allergen or a supplemental allergen or material. Patients included in the study group also had a final patch test interpretation of “allergic” and a final primary diagnosis of ACD. A comparison group included individuals with a final primary diagnosis of ACD and no medical adhesive source.

A total of 313 patients (78.5% women; 63.1% age >40 years) were included in the study group, and 20,131 comprised the comparison group (68.1% women; 69.3% age >40 years).

The study group participants were less likely to be men (odds ratio [OR] 0.58; CI, 0.45-0.77) and less likely to be older than age 40 years (OR 0.76; CI, 0.6-0.96) vs the comparison group. The trunk was the most common dermatitis site (24.0%), followed by scattered generalized dermatitis (22.7%).

Colophony was the most frequently occurring screening series allergen, accounting for 80.7% of positive reactions in 259 patients, and the percentage of colophony positivity was fairly constant over time. Other allergens that were identified included balsam of Peru (3.9%), 2-hydroxyethyl methacrylate (2-HEMA) (2.7%), carba mix (2.7%), thiuram mix (2.3%), and methyl methacrylate (MMA) (2.3%).

In addition, 25.2% of 313 patients with medical adhesive contact allergy had 1 or more positive patch test reactions to a supplemental allergen or material, and 17.3% only had a positive reaction to a supplemental allergen or material.

An occupation-related medical adhesive contact allergy occurred in 3.5% of the 313 patients. Among the 10 patients for whom occupational information was available, 5 patients had professional specialty occupations (4 registered nurses, 1 physician).

The investigators noted that comprehensive patch testing results may be susceptible to referral population selection bias and not representative of the general dermatology population. Also, patch test interpretation depends on clinical judgment, and details of supplemental allergens and materials were not available, limiting applicability, they wrote.

“One quarter of patients had at least 1 medical adhesive allergen/material identified on supplemental testing, demonstrating the importance of testing supplemental allergens and materials,” stated the researchers.

Disclosure: Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Atwater AR, Bembry R, Liu B, et al. Medical adhesive allergens: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2018. J Am Acad Dermatol. Published online December 4, 2021. doi: 10.1016/j.jaad.2021.11.055