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The role of acrylic acid impurity as a sensitizing component in electrocardiogram electrodes
Luca Stingeni1, Emilia Cerulli1, Anna Spalletti2
1Section of Clinical, Allergological and Venereological Dermatology, Department of Medicine, University of Perugia, 06156, Perugia, Italy.
Background:
Allergic contact dermatitis caused by (meth)acrylates is well known, both in occupational and in non-occupational settings. Contact hypersensitivity to electrocardiogram (ECG) electrodes containing (meth)acrylates is rarely reported.
Objective:
To report the first case of contact dermatitis caused by acrylic acid impurity in ECG electrodes.
Materials And Methods:
Patch tests were performed with separate components of electrodes and some (meth)acrylates. This was followed by high-performance liquid chromatography of electrode hydrogel.
Results:
The patient was contact-allergic to electrode hydrogel but not to its separate constituents. Positive reactions were observed to 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxypropyl methacrylate (2-HPMA) and ethyleneglycol dimethacrylate (EGDMA). Subsequent analysis showed that the electrode hydrogel contained acrylic acid as an impurity. The latter was subsequently patch tested, with a positive result.
Conclusion:
The sensitization resulting from direct contact with ECG electrodes was caused by acrylic acid, present as an impurity in ECG electrodes. Positive reactions to 2-HEMA, 2-HPMA and EGDMA are considered to be cross-reactions.
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