Allergic contact dermatitis from modified colophonium in wound dressings. 2007

Teresa M Pereira, and Maria Flour, and An Goossens
Serviço de Dermatologia e Venereologia, Hospital de São Marcos, Braga, Portugal.

This study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices.

UI MeSH Term Description Entries
D007871 Leg Ulcer Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (VARICOSE ULCER), 5% to arterial disease, and the remaining 5% to other causes. Leg Ulcers,Ulcer, Leg,Ulcers, Leg
D010328 Patch Tests Skin tests in which the sensitizer is applied to a patch of cotton cloth or gauze held in place for approximately 48-72 hours. It is used for the elicitation of a contact hypersensitivity reaction. Patch Testing,Patch Test,Patch Testings,Test, Patch,Testing, Patch,Testings, Patch,Tests, Patch
D012116 Resins, Plant Flammable, amorphous, vegetable products of secretion or disintegration, usually formed in special cavities of plants. They are generally insoluble in water and soluble in alcohol, carbon tetrachloride, ether, or volatile oils. They are fusible and have a conchoidal fracture. They are the oxidation or polymerization products of the terpenes, and are mixtures of aromatic acids and esters. Most are soft and sticky, but harden after exposure to cold. (From Grant & Hackh's Chemical Dictionary, 5th ed & Dorland, 28th ed) Plant Resins
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D017449 Dermatitis, Allergic Contact A contact dermatitis due to allergic sensitization to various substances. These substances subsequently produce inflammatory reactions in the skin of those who have acquired hypersensitivity to them as a result of prior exposure. Allergic Contact Dermatitis,Dermatitis, Allergic Eczematous,Dermatitis, Contact, Allergic,Allergic Contact Dermatitides,Allergic Eczematous Dermatitides,Allergic Eczematous Dermatitis,Contact Dermatitides, Allergic,Contact Dermatitis, Allergic,Dermatitides, Allergic Contact,Dermatitides, Allergic Eczematous,Eczematous Dermatitides, Allergic,Eczematous Dermatitis, Allergic
D047070 Bandages, Hydrocolloid Dressings comprised of a self-adhesive matrix to which hydrophilic absorbent particles are embedded. The particles consist of CELLULOSE derivatives; calcium ALGINATES; PECTINS; or GELS. The utility is based on providing a moist environment for WOUND HEALING. Bandages, Hydrogel,Duoderm,Hydrocolloid Dressing,Bandage, Hydrocolloid,Bandage, Hydrogel,Dressing, Hydrocolloid,Dressings, Hydrocolloid,Hydrocolloid Bandage,Hydrocolloid Bandages,Hydrocolloid Dressings,Hydrogel Bandage,Hydrogel Bandages

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