Allergic contact dermatitis caused by isobornyl acrylate in OmniPod, an innovative tubeless insulin pump

Abstract

Background: The frequency of allergic contact dermatitis caused by (meth)acrylates is increasing worldwide, and isobornyl acrylate (IBOA) has been identified as a culprit sensitizer in FreeStyle Libre, a medical device used by diabetic patients. Objectives: To report on 4 patients sensitized to IBOA contained in OmniPod, a new, tubeless insulin pump, and to describe the clinical and chemical analytical work-up. Method: Four patients with eczematous skin eruptions after using OmniPod, including 2 with previous adverse skin reactions to FreeStyle Libre, were patch tested with a baseline series and additional (meth)acrylates, including IBOA in several concentrations and/or vehicles. Gas chromatography-mass spectrometry (GC-MS) was used to identify the presence of IBOA in OmniPod. Results: All patients were shown to be sensitized to IBOA. GC-MS identified IBOA in OmniPod, with the highest concentrations being found in the unit itself and not in the adhesive patch. Conclusions: The OmniPod tubeless insulin pump is another source of IBOA, and its use may lead to primary sensitization to this acrylate, or may provoke elicitation of allergic contact dermatitis in previously sensitized patients. Our cases highlight the need to obtain satisfactory cooperation from pharmaceutical companies involved in the manufacture of these widely used medical devices.