Contact allergy to insulin pumps.

Linked Article: Ulriksdotter et al. Br J Dermatol 2022; 186:334–340. Patients with type 1 diabetes need insulin injections to control their blood glucose levels. Pumps have been developed that continuously release the right amount of insulin. The pump is stuck to the skin and patients may also have a glucose sensor stuck in a different place. Unfortunately, many patients develop contact allergy to the pump or adhesive, causing sore, red, skin (dermatitis) underneath the pump. This paper from Sweden describes this problem in three patients using the Omnipod® pump: a 40‐year‐old woman and boys aged 8 and 10 years. It took 6 to 18 months for the allergy to first appear, but after that the dermatitis would develop within 24 hours wherever the pump was placed. Steroid creams and thin hydrocolloid dressings (DuoDERM®) under the pump did not solve the problem. None of them had previously had eczema, but two also had reactions to their glucose sensors. These patients and 23 individuals without diabetes were patch‐tested with various substances found in medical devices and skin adhesives. Suspected allergens mixed with solvent or petrolatum are left on the skin for at least 3 days. All three showed positive reactions to a newly recognized allergen called dipropylene glycol diacrylate (DPGDA) and to other related substances. DPGDA was present in the adhesive patches and pumps used by these patients, but a pump from an earlier batch was negative. This highlights that medical devices contain undeclared sensitizers that change over time. Multiple allergies in users are increasingly common and hard to identify and treat. Linked Article: Ulriksdotter et al. Br J Dermatol 2022; 186:334–340. [ABSTRACT FROM AUTHOR]