Colophonium-related Allergic Contact Dermatitis Caused by Medical Adhesive Tape Used to Prevent Skin Lesions in Soldiers
DOI:
https://doi.org/10.2340/actadv.v103.18428Keywords:
allergic contact dermatitis, colophonium, contact allergy, medical device, military personnel, occupational dermatitisAbstract
Medical adhesive tapes are commonly recommended for the prevention of friction blisters during hiking and military marches. The aim of this paper is to report on the results of investigations into an outbreak of tape-related foot dermatitis in 26 military conscripts following continuous use of medical adhesive tapes for several days during a field exercise. Patch tests were performed using baseline series and aimed testing was performed with colophonium-related substances and different medical adhesive tapes. Contact allergy to the adhesive tapes used was found in 20 (77%) subjects, and contact allergy to colophonium in 16 (61%). Chemical analysis detected colophonium-related substances in the culprit tapes. Compared with consecutive dermatitis patients investigated at our Department of Occupational and Environmental Dermatology in the previous 10 years, conscripts with colophonium allergy had increased odds ratios for concomitant contact allergy to phenol formaldehyde resins and fragrance substances including hydroperoxides of limonene and linalool. The results show that prolonged use of medical adhesive tapes on intact skin carries a high risk for allergic contact dermatitis. Prior to their introduction on the market, medical devices should be assessed for possible side-effects.
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Atwater AR, Bembry R, Liu B, Warshaw EM, DeKoven JG, Silverberg JI et al. Medical adhesive allergens: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2018. J Am Acad Derm 2022; 87: 1024-1032.
https://doi.org/10.1016/j.jaad.2021.11.055 DOI: https://doi.org/10.1016/j.jaad.2021.11.055
Svedman C, Bruze M, Antelmi A, Hamnerius N, Hauksson I, Ulriksdotter J et al. Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less 'allergy- prone' devices: investigation and advice hampered by insufficient material for optimized patch test investigations. J Eur Acad Dermatol Venereol 2021; 35: 730-737.
https://doi.org/10.1111/jdv.16981 DOI: https://doi.org/10.1111/jdv.16981
Worthing RM, Percy RL, Joslin JD. Prevention of friction blisters in outdoor pursuits: a systematic review. Wilderness Environ Med 2017; 28: 139-149.
https://doi.org/10.1016/j.wem.2017.03.007 DOI: https://doi.org/10.1016/j.wem.2017.03.007
Hoffman MD. Etiological foundation for practical strategies to prevent exercise-related foot blisters. Current Sports Med Rep 2016; 15: 330-335.
https://doi.org/10.1249/JSR.0000000000000297 DOI: https://doi.org/10.1249/JSR.0000000000000297
Rushton R. The advanced guide to blister prevention. [accessed 2023 Mar 28] Available from: https://blisterprevpdfs.s3-ap-southeast-1.amazonaws.com/the+advanced+guide+to+blister+prevention+2013.pdf.
Nyholm L. LGs tejpskola - del 1, hälar. [accessed 2023 Mar 31]. Available from: https://www.youtube.com/watch?v=HjifI73fFs8.
Smith B. The stupidly easy way to prevent blisters. [accessed 2023 Mar 31]. Available from: https://www.mensjournal.com/health-fitness/stupidly-easy-way-prevent-blisters.
Cooper DL, Fair J. Contact dermatitis, benzoin, and athletic tape. Phys Sportsmed 1978; 6: 119.
https://doi.org/10.1080/00913847.1978.11710805 DOI: https://doi.org/10.1080/00913847.1978.11710805
Shono M, Ezoe K, Kaniwa MA, Ikarashi Y, Kojima S, Nakamura A. Allergic contact dermatitis from para-tertiary-butylphenol-formaldehyde resin (PTBP-FR) in athletic tape and leather adhesive. Contact Dermatitis 1991; 24: 281-2888.
https://doi.org/10.1111/j.1600-0536.1991.tb01723.x DOI: https://doi.org/10.1111/j.1600-0536.1991.tb01723.x
Christoffers WA, Coenraads PJ, Schuttelaar ML. Bullous allergic reaction caused by colophonium in medical adhesives. Contact Dermatitis 2014; 70: 256-257.
https://doi.org/10.1111/cod.12170 DOI: https://doi.org/10.1111/cod.12170
Svedman C, Dahlin J, Hamnerius N, Adwa U, Bruze M. Occupational allergic contact dermatitis induced by adhesives used for prevention of chafing in the military forces - a case report. Contact Dermatitis 2023; 89: 391-393.
https://doi.org/10.1111/cod.14398 DOI: https://doi.org/10.1111/cod.14398
Bruze M, Dahlquist I, Fregert S. Patch testing with colophony at 60% concentration. Contact Dermatitis 1986; 15: 193.
https://doi.org/10.1111/j.1600-0536.1986.tb01330.x DOI: https://doi.org/10.1111/j.1600-0536.1986.tb01330.x
Bruze M TL, Bendsøe N. Patch testing with ultrasonic bath extracts. Am J Contact Dermat 1992; 3: 133-137.
https://doi.org/10.1097/01634989-199209000-00004 DOI: https://doi.org/10.1097/01634989-199209000-00004
Fregert S. Manual of contact dermatitis. 2nd edn. Copenhagen: Munksgaard; 1981.
Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis 2015; 73: 195-221.
https://doi.org/10.1111/cod.12432 DOI: https://doi.org/10.1111/cod.12432
Hamnerius N, Mowitz M. Intense skin reaction to a new glucose monitoring and insulin pump system. Contact Dermatitis 2020; 83: 524-527.
https://doi.org/10.1111/cod.13663 DOI: https://doi.org/10.1111/cod.13663
Widman TJ, Oostman H, Storrs FJ. Allergic contact dermatitis from medical adhesive bandages in patients who report having a reaction to medical bandages. Dermatitis 2008; 19: 32-37.
https://doi.org/10.2310/6620.2008.07053 DOI: https://doi.org/10.2310/6620.2008.07053
Smith SM, Zirwas MJ. Nonallergic reactions to medical tapes. Dermatitis 2015; 26: 38-43.
https://doi.org/10.1097/DER.0000000000000098 DOI: https://doi.org/10.1097/DER.0000000000000098
Fall S, Bruze M, Isaksson M, Lidén C, Matura M, Stenberg B, et al. Contact allergy trends in Sweden - a retrospective comparison of patch test data from 1992, 2000, and 2009. Contact Dermatitis 2015; 72: 297-304.
https://doi.org/10.1111/cod.12346 DOI: https://doi.org/10.1111/cod.12346
Andernord D, Bruze M, Bryngelsson IL, Bråred Christensson J, Glas B, Hagvall L, et al. Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017). Contact Dermatitis 2022; 86: 175-188.
https://doi.org/10.1111/cod.13996 DOI: https://doi.org/10.1111/cod.13996
Diepgen TL, Ofenloch RF, Bruze M, Bertuccio P, Cazzaniga S, Coenraads P-J et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol 2016; 174: 319-329.
https://doi.org/10.1111/bjd.14167 DOI: https://doi.org/10.1111/bjd.14167
Lagrelius M, Wahlgren CF, Matura M, Kull I, Liden C. High prevalence of contact allergy in adolescence: results from the population-based BAMSE birth cohort. Contact Dermatitis 2016; 74: 44-51.
https://doi.org/10.1111/cod.12492 DOI: https://doi.org/10.1111/cod.12492
Bruze M. Simultaneous reactions to phenol-formaldehyde resins colophony/hydroabietyl alcohol and balsam of Peru/perfume mixture. Contact Dermatitis 1986; 14: 119-120.
https://doi.org/10.1111/j.1600-0536.1986.tb01178.x DOI: https://doi.org/10.1111/j.1600-0536.1986.tb01178.x
Karlberg AT, Dooms-Goossens A. Contact allergy to oxidized d-limonene among dermatitis patients. Contact Dermatitis 1997; 36: 201-206.
https://doi.org/10.1111/j.1600-0536.1997.tb00270.x DOI: https://doi.org/10.1111/j.1600-0536.1997.tb00270.x
Paulsen E, Andersen KE. Colophonium and Compositae mix as markers of fragrance allergy: cross-reactivity between fragrance terpenes, colophonium and compositae plant extracts. Contact Dermatitis 2005; 53: 285-291.
https://doi.org/10.1111/j.0105-1873.2005.00704.x DOI: https://doi.org/10.1111/j.0105-1873.2005.00704.x
Dear K, Palmer A, Nixon RL. Allergic contact dermatitis to phenol-formaldehyde resin at a single tertiary dermatology centre. Contact Dermatitis 2021; 85: 26-31.
https://doi.org/10.1111/cod.13771 DOI: https://doi.org/10.1111/cod.13771
Aerts O, Dendooven E, Raison-Peyron N. Sensitization to modified colophonium in glucose sensors: another problem for diabetes patients. Contact Dermatitis 2022; 87: 553-555.
https://doi.org/10.1111/cod.14213 DOI: https://doi.org/10.1111/cod.14213
Isaksson M, Bruze M, Björkner B, Niklasson B. Contact allergy to Duraphat. Scandinavian J Dent Res 1993; 101: 49-51.
https://doi.org/10.1111/j.1600-0722.1993.tb01646.x DOI: https://doi.org/10.1111/j.1600-0722.1993.tb01646.x
Bruze M. Systemically induced contact dermatitis from dental rosin. Scand J Dent Res 1994; 102: 376-378.
https://doi.org/10.1111/j.1600-0722.1994.tb01487.x DOI: https://doi.org/10.1111/j.1600-0722.1994.tb01487.x
Dendooven E, Foubert K, Naessens T, Pieters L, Lambert J, Goossens A et al. Allergic contact dermatitis from ("hypoallergenic") adhesives containing D-limonene. Contact Dermatitis 2022; 86: 113-119.
https://doi.org/10.1111/cod.14008 DOI: https://doi.org/10.1111/cod.14008
Mills AA. Canada balsam. Ann Sci 1991; 48: 173-185.
https://doi.org/10.1080/00033799100200191 DOI: https://doi.org/10.1080/00033799100200191
Karlberg A-T, Hagvall L. Colophony: rosin in unmodified and modified form. In: John SM, Johansen JD, Rustemeyer T, Elsner P, Maibach HI, editors. Kanerva's occupational dermatology. Cham: Springer International Publishing; 2018. p. 1-18.
https://doi.org/10.1007/978-3-319-40221-5_41-2 DOI: https://doi.org/10.1007/978-3-319-40221-5_41-2
Knapik J, Reynolds K, Staab J, Vogel JA, Jones B. Injuries associated with strenuous road marching. Mil Med 1992; 157: 64-67.
https://doi.org/10.1093/milmed/157.2.64 DOI: https://doi.org/10.1093/milmed/157.2.64
Reynolds KL, White JS, Knapik JJ, Witt CE, Amoroso PJ. Injuries and risk factors in a 100-mile (161-km) infantry road march. Prev Med 1999; 28: 167-173.
https://doi.org/10.1006/pmed.1998.0396 DOI: https://doi.org/10.1006/pmed.1998.0396
Brennan FH, Jr., Jackson CR, Olsen C, Wilson C. Blisters on the battlefield: the prevalence of and factors associated with foot friction blisters during Operation Iraqi Freedom I. Mil Med 2012; 177: 157-162.
https://doi.org/10.7205/MILMED-D-11-00325 DOI: https://doi.org/10.7205/MILMED-D-11-00325
Lärobok preventiv medicin grunder. Stockholm: Försvarsmakten; 2016 [Textbook of basic preventive medicine. Stockholm. Swedish Armed Forces; 2016]. p. 28-31.
Asarani NAM, Reynolds AN, Boucher SE, de Bock M, Wheeler BJ. Cutaneous complications with continuous or flash glucose monitoring use: systematic review of trials and observational studies. J Diabetes Sci Tech 2020; 14: 328-137.
https://doi.org/10.1177/1932296819870849 DOI: https://doi.org/10.1177/1932296819870849
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