Allergic contact dermatitis caused by Dermabond ®

A 30-year-old patient presented with a pruritic rash on the thighs 24 h after knee surgery, in which Dermabond® had been used for wound closure. The pruritic rash had extended within a few hours. The initial lesions showed localized eczema, followed within 24 h by a poorly defined erythematous, partly papular/urticarial and vesicular rash that extended to the thigh (Fig. 1). The patient was treated with antihistamines and topical corticosteroids. Three months later, patch testing was performed with the European baseline series (including formaldehyde 1% aq.), an acrylate series, and Dermabond® ‘as is’. The patch tests were applied to the patient’s upper back with IQ Ultra® chambers (Destaing Laboratory, Grasse, France) for 2 days. As previously described (1), we also performed scratch tests with Dermabond®, with a mixture (1:1) of Dermabond® and povidone iodine (1% aq.), and with a mixture of Dermabond® and chlorhexidine (0.2% aq.), in order to reproduce the conditions of use. Povidone iodine and chlorhexidine were also both tested alone in the above-mentioned concentrations. Readings, performed according to ESCD guidelines (2), were performed on day (D) 2 and D3. Only scratch tests gave positive