Allergic contact dermatitis to 2-octyl cyanoacrylate after surgical repair: Humidity as a potential factor

A llergic contact dermatitis to 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, NJ) after surgical repair is an extremely rare condition with few reported cases. In recent years, contact dermatitis to Dermabond has been reported with increasing frequency. Cyanoacrylates are the most commonly used surgical adhesives and rely on their rapid polymerization to prevent sensitization from antigen presenting cells (APCs), because APCs are only capable of monomeric recognition of cyanoacrylates. It is thought that arid climates may contribute to increased sensitization of cyanoacrylates because water drives the polymerization reaction, decreasing the number of monomers capable of recognition by APCs. With less water present in the air to drive the polymerization forward, it is thought that monomers will persist longer, providing APCs more time to become sensitized. Indeed, most cases of allergic contact dermatitis to Dermabond published in the literature are from arid environments, such as a case from Las Vegas, Nevada and 4 cases from San Antonio, Texas. These observations should in theory extend to home heaters and air conditioners. We present a case of allergic contact dermatitis to 2-octyl cyanoacrylate after the use of a home heater shortly after application.