Allergic contact dermatitis caused by glucose sensors in type 1 diabetes patients.

BACKGROUND: Allergic contact dermatitis caused by glucose sensors has become an increasing problem. Contact allergies to isobornyl acrylate, colophonium, ethyl cyanoacrylate and N,N-dimethylacrylamide have been reported. However, there is a paucity of information regarding the prevalence of sensor-related dermatitis and detailed patient histories. OBJECTIVES: To evaluate diabetes patients who have developed allergic contact dermatitis caused by glucose sensors. PATIENTS AND METHODS: Seventy patients with suspected contact allergy to glucose sensors referred to university hospital dermatology clinics in southern Finland were patch tested with the baseline series, an isobornyl acrylate dilution series, and a number of other acrylates. Atopic constitution, contact allergies, the severity of the dermatitis and the ability to continue with the same or another type of sensor were recorded. RESULTS: Positive patch test reactions to isobornyl acrylate were seen in 51 of 63 (81%) Freestyle Libre users. Colophonium or its derivatives gave positive reactions in five of seven Medtronic Enlite users. The median duration of sensor use before dermatitis was 6 months. The estimated prevalences of contact allergy to sensor adhesives were 0.7% for Freestyle Libre and 0.8% for Enlite. CONCLUSIONS: We suggest that patients who have difficulties in finding a tolerable glucose sensor or an insulin pump should be patch tested.

[Hereditary angioedema]. / Perinnöllinen angioödeema.

Hereditary angioedema (HAE) is a rare autosomal dominant disease characterized by episodic swelling of the face, extremities, larynx, gastrointestinal tract or genitals. Three different subtypes have been identified so far. Type I and II HAE are caused by mutations in the C1 inhibitor gene leading to decreased or dysfunctional C1 inhibitor, respectively. Type III is caused by a mutation in the coagulation factor XII. In addition, acquired forms or forms with no known etiology exist. Increased bradykinin production leading to increased vessel permeability is common to all HAE types. Treatment of HAE has evolved dramatically during the last years as self-administration of C1 inhibitor concentrate and bradykinin-2 receptor antagonist icatibant have become available.

[Update on current care guidelines. Bacterial skin infections]. / Ihon bakteeri-infektiot.

Bacterial skin infections are common, and range from mild to serious, even life-threatening infections. This guideline presents treatment options for erysipelas, cellulitis, impetigo, ecthyma, folliculitis, abscess, paronychia (nail infection) and early borreliosis as well as for erysipeloid, mycobacterial skin infections and tularemia. Recommended antibiotic and/or other treatments are described for children and adults.