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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 5  |  Issue : 3  |  Page : 57-58

Irritant contact dermatitis to medical adhesive bandage: An occasional sticky problem


Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India

Date of Submission22-Jul-2020
Date of Acceptance11-Aug-2020
Date of Web Publication26-Jul-2021

Correspondence Address:
Dr. Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani - 263 139, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MTSM.MTSM_32_20

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How to cite this article:
Dharmshaktu GS. Irritant contact dermatitis to medical adhesive bandage: An occasional sticky problem. Matrix Sci Med 2021;5:57-8

How to cite this URL:
Dharmshaktu GS. Irritant contact dermatitis to medical adhesive bandage: An occasional sticky problem. Matrix Sci Med [serial online] 2021 [cited 2021 Oct 16];5:57-8. Available from: https://www.matrixscimed.org/text.asp?2021/5/3/57/322329



Dear Editor,

Allergies to medical adhesive bandages is uncommon clinical problems despite being widely used procedures in both outpatient and inpatient settings.[1] While studies based on patch tests reveal that proven allergic contact dermatitis (ACD) is infrequent and most cases might result from irritant reaction or irritant contact dermatitis (ICD). Tape allergy is reported by 0.3% of patients in a large scale electronic record-based study and also concluded that true tape allergy is rare. Most of these are nonallergic tape reactions.[2] Other complication of adhesive dressing or medical adhesive related skin injuries are erosion, vesicle or bullae formation, skin tears, maceration, or folliculitis.[3] Plastic-like chemicals called acrylates or propenoates are also responsible for some allergic reaction from bandage adhesive tapes.

A 12-year-old male child was brought to us with a history of injury to the left shoulder region. Radiographs revealed distal clavicular fracture with mild acromioclavicular subluxation. A strapping by adhesive tape (Stretchoplast®, CPL, Chetna Polytex Pvt. Ltd., India) was done supported by an arm pouch sling. The complaints of itchiness in the area covered by tape next day lead to removal of the dressing. There was a patch of skin rash with few vesicles in the area covered by tape [Figure 1]. There were no systemic feature of inflammation, infection or hypersensitivity and patient was stable. The area was washed with sterile water and lacto-calamine lotion was applied as emollient and smoothening agent. The skin condition healed in the following 5 days without recurrence or remote complication.
Figure 1: The clinical picture of irritant contact dermatitis over wide spread skin area covered by the adhesive tape

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A thorough medical history and documentation about any known presence and type of skin allergies at the time of admission by doctor and in the ward by nursing staff is good policy. ICD usually occurs within few hours in the form of crusts, erosion, vesicles, or scaling.[4] Patch testing, that is, gold standard should be advised in all cases to know more about the type of allergen.[5] Avoidance or removal of allergen, emollients for protective skin barrier, and use of anti-histamine for pruritus are generalized treatment. Serious cases may require topical corticosteroid on specialist consultation. Usually, most of the newer available adhesive dressings (like surgical cloth tape) tapes are hypoallergenic for a safer experience. ACD, on the other hand, is serious complication and knowledge and anticipation of this entity should be known to nursing staff and the standard operating principles regarding further management should be tailored. These cases are uncommon but frequently remind us of acknowledgement of these rare events and should make us prepared for the next occurrence.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
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;19:32-7.  Back to cited text no. 1
    
2.
Smith SM, Zirwas MJ. Nonallergic reactions to medical tapes. Dermatitis 2015;26:38-43.  Back to cited text no. 2
    
3.
LeBlanc K. Medical Adhesive-Related Skin Injuries (MARSI). Available from: https://www.woundsource.com/patientcondition/medical-adhesive-related-skin-injuries-marsi. [Last accessed on 2020 Jun 02].  Back to cited text no. 3
    
4.
Glenn Y. When your patient is sensitive to tape. Nursing 2006;36:17.  Back to cited text no. 4
    
5.
Nelson JL, Mowad CM. Allergic contact dermatitis: Patch testing beyond the TRUE test. J Clin Aesthet Dermatol 2010;3:36-41.  Back to cited text no. 5
    


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