2021. Aliment. Patient demographics are presented in Table 1. Hysterectomy is one the most commonly performed surgeries in women in the United States. Objectives, Submission, Review, & Therefore, this study aimed to investigate the incidence of ACD after the use of 2-octyl cyanoacrylate and n-butyl cyanoacrylate topical skin adhesives and to determine whether there are any risk factors for their occurrence. 8 Days Post Hysterectomy Allergic Reaction to Dermabond - Help! Off-label medical use was widespread in many surgical specialties and dentistry by the 1980s especially throughout Europe. Skin hypersensitivity following application of tissue adhesive (2-octyl cyanoacrylate). I had a severe allergic reaction to the antiseptic they put all over your abdomen and thighs prior to surgery( Chlorahexadine glucanate). 0000047688 00000 n The https:// ensures that you are connecting to the Skin Wound Care 30, 272286 (2017). Embedded Dermabond may result in a foreign body reaction.8 This report describes contact dermatitis from the use of Dermabond. Postoperative dressing was performed with povidone-iodine, which was also used for preoperative skin preparation, at intervals of 23days for up to 2weeks after surgery. Feature Flags: { A rash around a surgical incision is fairly common. 16 September 2014. The American Academy of Dermatology Association (AADA) says that to determine the type of rash you have and whats causing it, your doctor will consider your health history and perform a physical exam. The material is rapidly converted from a liquid to a solid state via polymerization at room temperature without the need for a catalyst, evaporation of a solvent or application of pressure [5]. Thank you for visiting nature.com. In addition, the sutureless closure has become a marketing tool for surgeons. hasContentIssue false, Correspondence: Joseph A. Ricci, MD Division of Plastic Surgery Brigham and Women's Hospital 75 Francis Street Boston, Massachusetts 02115 USA E-mail, Copyright World Association for Disaster and Emergency Medicine 2014. and Although 2-octyl cyanoacrylate and n-butyl cyanoacrylate are harmless to most patients, they can act as allergens and cause allergic contact dermatitis (ACD)15,16. Blackmore, Sid Dermal Hypersensitivity Reaction to Semaglutide: Two Case Reports. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. Parkerson, Jamie Drug-related problems in hypertension and gestational diabetes mellitus: A hospital cohort. Dermabond is a liquid topical skin adhesive containing a monomeric 2-octyl cyanoacrylate formulation and the colorant D&C Violet #2 which should slough off with desquamation of the epidermis 7-14 days after application. This can indicate infection, which needs to be treated right away. It will end, though. 2020 John Wiley & Sons A/S . ct1qJq7?03Y1n`UA4/EQfcs&80.e` Received date: May 07, 2018 Accepted date: May 23, 2018 Published date: May 28, 2018. 69, 763781 (2012). 2014; 29 (5): 1-3. Johansen JD, Aalto-Korte K, Agner T, et al. RicciJA, ParekhNN, DesaiNS. Sarukawa, Shunji Methods: Orthopedics. Longer-chained cyanoacrylates, such as the 2-octyl cyanoacrylate monomer present in Dermabond, releases less degradation products than the short-chained monomers thus producing less potential histotoxicity. Incidence and risk factor of allergic contact dermatitis to 2-octyl cyanoacrylate and n-butyl cyanoacrylate topical skin adhesives, https://doi.org/10.1038/s41598-021-03319-3. Gearhart, Peter A. What steps should be taken if a patient experiences a local reaction or hypersensitivity to . Systemic steroids are the mainstay of treatment; however, topical petrolatum-based steroids not only treat symptoms but also dissolve the Dermabond. Of note, the patient underwent a tubal ligation one year before this procedure. Med. 0000060206 00000 n (2015). 2018 Gorski J. 0000002289 00000 n 120, 14601465 (2007). The use of dermabond(R) as an adjunct to wound closure after total knee arthroplasty: Examining immediate post-operative wound drainage. Generally, very few complications are associated with Dermabond and are usually related to application techniques. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. The rash began three weeks after the procedure, directly over . The clinical characteristics of patients with allergic contact dermatitis (ACD) due to a skin adhesive containing 2-octyl cyanoacrylate, Dermabond, have not yet been elucidated. We deduced that this is due to its lower popularity than 2-octyl cyanoacrylate as a topical skin adhesive. This decline has been attributed to the introduction of minimally invasive techniques such as uterine artery embolization for the treatment of leiomyomata and non-surgical ablative therapies that are now commonly used for abnormal benign uterine bleeding [1]. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. To date, ACD to topical skin adhesives has been continuously reported in case reports of sporadic events, but systematic studies on their incidence and risk factors have been limited. Physician 82, 249255 (2010). After DERMABOND PRINEO System is applied, how will the surgeon assess whether the wound is healing Her husband, a physician, feared infection and prescribed 1 g of intramuscular ceftriaxone (Rocephin; Roche Laboratories, Nutley, NJ) and oral sulfamethoxazole/trimethoprim (Bactrim DS; Roche Laboratories). the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Allergic Contact Dermatitis to Dermabond Prineo After Elective Orthopedic Surgery. Current knowledge assembled at an international workshop at BfR, Germany. The surgeon and infectious disease physician agreed that her erythema was an allergic reaction to the Dermabond. and Although cyanoacrylates traditionally have been associated with low rates of sensitization, allergic contact dermatitis (ACD) to Dermabond products is being increasingly reported after orthopedic surgery. Do they pose any danger to your health? Wright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, et al. You are using a browser version with limited support for CSS. CAS A 63-year-old female presented on post-operative day 7 status post total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with sudden onset erythema and pruritus around all four port site incisions. This second exposure to Dermabond caused an intense contact dermatitis that readily resolved with steroid use. 105, 409420 (2000). This report describes a rare case of a diffuse cutaneous allergic reaction to Dermabond following its use to close a surgical incision, its prompt identification, and treatment after presentation to an emergency department. The .gov means its official. Ghaferi, A. Thus, the increasingly large number of hysterectomies being performed with traditional laparoscopic and robotically-assisted laparoscopic techniques may contribute to a gross underestimation of the actual number accomplished. Would you like email updates of new search results? 7 status post total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with sudden onset of erythema and pruritus around all four port site incisions (Figure 1). Clinical photograph of a patient showing well-demarcated pruritic eczematous eruption, papules, and vesicles that developed in the skin area to which topical skin adhesive was applied. 0000055840 00000 n Uncommonly, patients present with allergic reactions to the adhesive compounds; these allergies are often misdiagnosed as cellulitis or another infectious process, and are incorrectly treated. The distinction between infection and contact dermatitis is critical. Diffuse Cutaneous Allergic Reaction to Dermabond. The dermatologist made recommendation to apply a thin topical layer of hydrocortisone 1% to affected areas two to four times per day. All patients underwent foot and ankle surgeries, which were performed by two orthopedic surgeons. She was afebrile. 16, 146150 (2006). The adhesive property of the compound methyl 2-cyanoacrylate was first described in the literature by H.W. Thus, allergic reactions should only increase as laparoscopic and robotically assisted hysterectomy replace open abdominal and vaginal techniques. Durando, D. et al. Heat rash is a skin condition that often affects children and adults in hot, humid weather conditions. Technol. Concerns of tissue toxicity eventually excluded methyl 2-cyanoacrylate from use on human tissue [12]. After that, a standard absorbent dressing was applied and changed on the second day after surgery. In addition, in joint arthroplasty surgery, Michalowitz et al.23 reported an incidence of 1.8% in 281 patients and Durando et al.24 reported 1.7% in 912 patients. 2021 Jun 15;34(6):736-738. doi: 10.1080/08998280.2021.1935140. dermabond - allergic reaction Need Answers? Article Google Scholar government site. Postoperative results following the resolution of this allergic reaction are shown in Figure 3. Commentary on: Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy? Close this message to accept cookies or find out how to manage your cookie settings. In some cases, your doctor may want to perform a skin biopsy as well. It looks like iodine. Post-surgical contact dermatitis is a localized rash that is almost always a reaction to something that came into contact with your skin. Plast. J.S.C. The Neuroanatomy of Poststroke Subjective Sensory Hypersensitivity. As ACD occurs without risk factors in 23% of patients who used 2-octyl cyanoacrylate or n-butyl cyanoacrylate topical skin adhesives, clinicians and patients should be aware of these facts before using topical skin adhesives. Federal government websites often end in .gov or .mil. hb``d``;d|gb@ !; M$i``H~ 8Lt:$SuO8u$iHxrNDGQIgIB4YA]HN[RR1(z/o>O:Z)wSQ> J:::2 In fact, n-butyl cyanoacrylate is increasingly preferred for vascular embolization, bleeding hemostasis, or corneal injury repair over skin closure30,31,32. Elzomor, Amir 2017 Dec;77(6):414-415. doi: 10.1111/cod.12823. Surgical site infection should always be considered when evaluating a potential allergic reaction to Dermabond or other skin adhesive. She was afebrile and looked well. Would you like email updates of new search results? Osmond, M. H., Quinn, J. V., Sutcliffe, T., Jarmuske, M. & Klassen, T. P. A randomized, clinical trial comparing butylcyanoacrylate with octylcyanoacrylate in the management of selected pediatric facial lacerations. Dermabond allergy is a rare event, but one that needs to be recognized and treated promptly. How common is it to have a rash after surgery? to worldwide, enabling them to utilize available resources effectively. YU==lmKgrk]=|>FWxMfhu89fdo{.KZJX_8x-.V)tI]B -+S5|r`(`i%u.h-QuK-Z[>>>>%k Your doctor should be notified of any symptoms of infection, so treatment can begin immediately. That's a shame about being allergic to the dermabond! Sachse MM, Junghans T, Rose C, Wagner G (2013) Allergic contact dermatitis caused by topical 2-octyl-cyanoacrylate. Most of these studies have highlighted concerns like allergic reactions following the use of Dermabond Prineo [10, 24,25,26,27,28,29 . I have hypothyroidism and take armour and metformin . In rare cases, scratching or otherwise irritating the rash can result in a skin infection. Google Scholar. Ricci JA, Parekh NN, Desai NS. The use of 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, NJ) for wound closure is increasingly popular. 0000010940 00000 n Yagnatovsky M, Pham H, Rokito A, Jazrawi L, Strauss E. Phys Sportsmed. OA Texts journals are led by prominent Davis M, Stuart M. Severe allergic dermatitis to dermabond prineo, a topical skin adhesive of 2-octyl cyanoacrylate increasingly used in surgeries to close wounds. White spots on your nipples are usually harmless. 121 0 obj <> endobj Conclusions: If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Poore, Samuel O. In this retrospective study, 577 patch tested patients were included. ~%_W+`Su3-x3LX8pg u Past medical history is significant for stage 0 DCIS, chronic hypertension and migraine headache. Dr. Perry was previously a paid consultant to Ethicon, a Division of Johnson & Johnson and the makers of Dermabond. Chen, Alex Abdomen of 63-year-old patient on post-operative day 7 with sudden onset erythema and pruritus surrounding the umbilical, left upper abdominal, left lower abdominal and right lower abdominal 5-mm trocar sites. Ardis AE (1949) US patent nos. The patient's husband eventually excised the residual Dermabond and reclosed the wound. Prog. and transmitted securely. Bookshelf redness or discoloration, or visible rash, skin blisters that may drain fluid (especially if you scratch at the rash), a rash that appears quickly, spreads, and covers all or most of your body, shortness of breath or difficulty breathing, antibiotics if your rash is caused by an infection, prescription anti-inflammatory medications, a replacement medication if your rash was caused by a drug allergy. and I also found that taking liquid Benedryl before bed really helped too. Occupational asthma has also been linked to exposure to cyanoacrylate adhesives used to affix sculpted acrylic artificial nails in beauty salons [28]. The trocars were removed, fascia closed with 0-vicryl suture and the skin edges were approximated and closed with two thin layers of Dermabond. A comparison of three methods of skin closure following repair of Achilles tendon rupture. 0000098852 00000 n I had an allergic reaction to dermabond after surgery (lipoma removal-23 incisions between knee and under breasts). Rash 101 in adults: When to seek medical treatment. and Disclaimer. Pediatr Emerg Care. To address this issue, we reviewed 1027 patients who underwent skin closure with 2-octyl cyanoacrylate and n-butyl cyanoacrylate topical skin adhesives to investigate the incidence and risk factors of ACD to topical skin adhesives. This polymerization is an exothermic reaction which may release significant heat [7]. Ther. 3Handschel JG Depprich RA Dirksen Det al. The AADA also says that a patch test can be done to determine if the rash is allergic contact dermatitis. Prior to this study, four studies have reported the incidence of ACD in the use of 2-octyl cyanoacrylate topical skin adhesive. 0000053193 00000 n J. In the trend of increasing the use of topical skin adhesives, these findings will help orthopedic surgeons attempt to use topical skin adhesives to predict ACD and provide information to patients. 2020 Nov 1;43(6):e515-e522. Krishnan, R., MacNeil, S. D. & Malvankar-Mehta, M. S. Comparing sutures versus staples for skin closure after orthopaedic surgery: systematic review and meta-analysis. Skin inflammation and pruritus abated completely within 2 days. Dermabond was first approved by the US Food and Drug Administration in 1998 and has steadily increased in popularity. Singer, A. J. Her wounds were closed with Vicryl sutures (Ethicon), deep dermal polydioxanone sutures (Ethicon), key sutures with Prolene (Ethicon), and Dermabond on the skin. Unlike 2-octyl cyanoacrylate, to the best of our knowledge, there has been no study on the incidence of ACD in n-butyl cyanoacrylate topical skin adhesives. Care must be taken to treat the symptoms of the allergic reaction while maintaining the integrity of the surgical incisions. One-Stage Augmentation Mastopexy: A Review of 1192 Simultaneous Breast Augmentation and Mastopexy Procedures in 615 Consecutive Patients. On day 6, the patient noted an enlarging nonpainful but significantly pruritic rash along the incision lines. Perry AW, Sosin M (2009) Severe allergic reaction to Dermabond. Arthur W. Perry, MD, Michael Sosin, Severe Allergic Reaction to Dermabond, Aesthetic Surgery Journal, Volume 29, Issue 4, July 2009, Pages 314316, https://doi.org/10.1016/j.asj.2009.02.019. 0000004069 00000 n In vivo study of wound bursting strength and compliance of topical skin adhesives. 2019 Sep/Oct;30(5):314-322. doi: 10.1097/DER.0000000000000514. further to my allergic reaction on Fri. HysterSisters Takes On Partner To Manage Continued Growth And Longevity. Close-up view of erythema surrounding the right lower abdominal 5-mm trocar site on post-operative day 7. Webster RG Jr, Slansky HH, Refojo MF, Boruchoff SA, Dohlman CH (1968) The use of adhesive for the closure of corneal perforations. Am J Otolaryngol. The authors did not receive support from any organization for the submitted work. Bouten, P. J. et al. 0000059447 00000 n Hak Jun Kim. et al. w5P 6 5N,i5E$3011aeax0d2b fc2ba41q?g+3dQ2 /:+c=2F-x..FDtT81a.Q|,/1E0|b Hysterectomy Recovery (post hysterectomy), HysterSisters Takes On Partner To Manage Continued Growth And Longevity. We report a case of a fulminant allergic reaction to Dermabond following a mastopexy. This report describes a rare case of a diffuse cutaneous allergic reaction to Dermabond following its use to close a surgical incision, its prompt identification, and treatment after presentation to an emergency department. 0000067772 00000 n HysterSisters.com is located at 111 Peter St, Toronto, Canada, M5V2H1 and is part of the VerticalScope network of websites. 2016 Mar-Apr;27(2):75-6. doi: 10.1097/DER.0000000000000163. These materials can irritate the skin or cause an allergic reaction in some people. The .gov means its official. 0000007745 00000 n Epub 2021 Dec 16. Its medical use quickly spread and interestingly, the first reported use of a cyanoacrylate tissue adhesive on the human eye occurred in 1968 [11]. Salazar, Peggy E. 0000006767 00000 n Am. 0000000016 00000 n Nakagawa, S. et al. (n.d.). Strategic Goals and Article May 2014 Amy Caton Christine E Dauphine View Severe dermatitis from Dermabond (R) surgical glue Article Oct. https://doi.org/10.1038/s41598-021-03319-3, DOI: https://doi.org/10.1038/s41598-021-03319-3. Sunaga, Ataru Ask your HysterSisters. Clin Case Studie Rep 1: DOI: 10.15761/CCSR.1000102. 2023 Healthline Media LLC. Skin patch testing performed three years after initial presentation was positive for ethyl cyanoacrylate. Shanmugam S, Wilkinson M (2012) Allergic contact dermatitis caused by a cyanoacrylate-containing false eyelash glue. Tissue adhesives for traumatic lacerations in children and adults. Slider with three articles shown per slide. We retrospectively reviewed 1145 patients (739 patients with 2-octyl cyanoacrylate and 406 patients with n-butyl cyanoacrylate) who underwent skin closure with topical skin adhesives. Collaborations, Submit All rights reserved. Orthop. Mc Donald BS, Buckley DA (2014) Severe dermatitis from Dermabond surgical glue. Clipboard, Search History, and several other advanced features are temporarily unavailable. For this reason, topical skin adhesives, which have the advantages of good scar cosmesis, infection prevention, easy skill acquisition, and lack of need for dedicated removal have begun to attract attention7,8,9,10,11,12,13. 2019. Did you have either adhesions or Interstitial Cystitis? ACD to topical skin adhesives usually presents as a self-limiting urticarial eruption near the incision site and subsides after proper local management. If an allergic reaction is encountered, Dermabond should be removed with petroleum jelly or acetone. Before Jacoby, Sidney M. All the study protocol were conducted in accordance with the relevant guidelines and regulations (STROBE guidelines)18. Skin edges must be absolutely apposed to prevent inversion of the wound edges, which results in wound separation once the Dermabond is removed. Parekh, Nirav N. They will examine the rash itself, noting its size, shape, color, severity, and other characteristics. Bethesda, MD 20894, Web Policies The increasing popularity of Dermabond in the gynaecologic operating room stems from its ease of use to close port site incisions at the end of laparoscopic surgery. Call 911 if you have: Simple home and over-the-counter (OTC) treatments can treat contact dermatitis as well. 0000015201 00000 n Dermabond is a liquid adhesive that contains the monomer of 2-octyl cyanocrylate (at a concentration of 94%). El-Gazzar, Y. et al. The variables used to determine the risk factors of ACD to topical skin adhesives were retrieved from electronic medical records. My chart since then says allergic to adhesives and latex. Am. At-home therapies for eczema and dermatitis. Treatment is simple and most cases will resolve within a few weeks. PMC Physical examination of the surgical incision sites revealed that they were all clean dry and intact. Of the 1145 patients included in the study, 32 (2.8%) patients were referred to dermatologists for suspected ACD after the use of a topical skin adhesive in the foot and ankle surgery, and 29 (2.5%) patients were diagnosed with ACD. (Log in options will check for institutional or personal access. i``5b@ k and It is a liquid that doctors apply on small wounds and skin surfaces to securely hold the edges together. 0000003918 00000 n I used hydrocortisone cream and pure aloe gel on the red patches. Bookshelf 0000056539 00000 n Published online by Cambridge University Press: Bethesda, MD 20894, Web Policies Three days postoperatively, she reported erythema around her incisions. Objective: Plast. Mr. Sosin has no financial interest in and receives no compensation from manufacturers of products mentioned in this article. All rights reserved. Intraoperatively, Veress needle entry was made into the abdominal cavity and a 5 mm trocar with scope was placed to visualize the abdominal cavity. Hysterectomy Defined Hysterectomy Facts Laparoscopic Hysterectomy Vaginal Hysterectomy Abdominal Hysterectomy Robotic . 0000017254 00000 n All data supporting our findings are contained within the manuscript. Endosc. Total loading time: 0 In the logistic regression analysis, age, sex, body mass index, diabetes, smoking, asthma, history of atopic dermatitis, history of contact dermatitis, neutrophil count, eosinophil count, and anatomical region did not show any correlation with the occurrence of allergic contact dermatitis (Table 2). The findings of this study showed that the incidence of ACD was 2.7% in 2-octyl cyanoacrylate and 2.2% in n-butyl cyanoacrylate, but none of the variables were found to increase the risk of ACD. It was so itchy! Singer, A. J., Perry, L. C. & Allen, R. L. Jr. in four of eight patients tested, and to 2-hydroxyethyl methacrylate in one of eight patients tested. Sci. 2022. Lee E, Elzomor A, Zwemer C, Chen A, Thakkar PG. The increased prevalence of keloids in atopic dermatitis patients with allergic comorbidities: a nationwide retrospective cohort study, Prospective, comparative clinical pilot study of cold atmospheric plasma device in the treatment of atopic dermatitis, Quality of life and therapeutic regimen management in onychomycosis patients and in vitro study of antiseptic solutions, Meta-analysis of the efficacy of preoperative skin preparation with alcoholic chlorhexidine compared to povidone iodine in orthopedic surgery, Phase 1 safety trial of a natural product cocktail with antibacterial activity in human volunteers, Topical administration of EGF suppresses immune response and protects skin barrier in DNCB-induced atopic dermatitis in NC/Nga mice, Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data, http://creativecommons.org/licenses/by/4.0/, Contact Dermatitis in the Inpatient Hospital Settingan Updated Review of the Literature. Bitterman A, Sandhu K. Allergic contact dermatitis to 2-octyl cyanoacrylate after surgical repair: humidity as a potential factor. Published by John Wiley & Sons Ltd. Although there are only a few surgical cases reported regarding allergic reaction to topical application of 2-octyl cyanoacrylate, the current literature is rife with allergic reaction to other cyanoacrylate formulations especially when used during previous surgeries as outlined (Table 1) [13,15-24]. 0000052838 00000 n This site needs JavaScript to work properly. Agreements, Confidentiality & Seven of 195 (3.6%) patients in Surgiseal, 13 of 544 (2.4%) patients in Dermabond Prineo, and nine of 406 (2.2%) patients in LiquiBand showed ACD. (2013) Nationwide trends in the performance of inpatient hysterectomy in the United States. 8600 Rockville Pike Vesicles similar to those seen with poison ivy were visible throughout all incisions, extending only to the area where Dermabond was applied (Figure 1). What Causes White Spots to Form on Your Nipple? It took over three weeks to go away. Liquid 2-octyl cyanoacrylate and n-butyl cyanoacrylate monomers are commonly used ingredients for topical skin adhesives because they polymerize into solid chains upon contact with the wound surface and hold wound edges together14. Register Clinical Trials, Guidelines for PubMedGoogle Scholar. Zwemer, Catherine 0000004792 00000 n 2017. 0000010468 00000 n Nine patients had positive patch test results to Dermabond; six had developed secondary generalization.The mean time between Dermabond application and ACD onset was 34 days (range, 27-44) in six patients with ACD after the first use, whereas, in the other three patients, it was 5.6 days (range, 4-8) after the second use. Here we report a case of allergic reaction secondary to use of Dermabond at Mount Sinai Hospital in New York, NY. Lindstrom I, Suojalehto H, Henriks-Eckerman ML, Suuronen K (2013) Occupational asthma and rhinitis caused by cyanoacrylate-based eyelash extension glues. %%EOF Of the three excluded patients, one had scabies and two had dyshidrotic eczema. (2021). Wound closure with 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, New Jersey USA) has recently increased in popularity across a wide spectrum of physicians ranging from surgeons to emergency medicine practitioners. Dermabond allergy is an extremely rare event. The next morning, with worsening erythema and itching, she was seen in the emergency room by the surgeon. But a cold compress or cooling pack (applied on top of clothing, not directly against the skin) will give your itch a bit of extra relief. Background: 17, 670672 (2010). Having any kind of surgery means being exposed to many materials and medications. Pediatr. Dunst KM, Auboeck J, Zahel B, Raffier B, Huemer GM (2010) Extensive allergic reaction to a new wound closure device (Prineo). The monomer polymerizes upon contact with the applicator tip, water, and exposure to body temperatures. Dermabond-induced ACD is apparently characterized by a high prevalence of primary sensitization at first exposure to Dermabond, secondary generalization is frequent, and most patients show cross-reactivity to ethyl cyanoacrylate. Hydrocortisone ointment was prescribed for the rash and to dissolve the Dermabond. Additional components of Dermabond include plasticizers that aid in the flexibility of the wound during the healing process, stabilizers to prolong the shelf life, and polymerization inhibitors to delay the transition of the product from liquid to solid.2 The polymer hydrolyzes in the body, creating formaldehyde, which causes inflammation.

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