Department of Dermatology, University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium.
Natural Products and Food Research and Analysis-Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium.
Contact Dermatitis. 2024 Nov;91(5):387-391. doi: 10.1111/cod.14670. Epub 2024 Aug 21.
Tert-butylphenol (TBP) derivatives, antioxidants in adhesives and diabetes devices, may provoke allergic contact dermatitis (ACD).
The objective of this study is to report sensitization to TBP derivatives in medical devices and to highlight that tert-butylhydroquinone (BHQ) and tert-butylcatechol (TBC) are potential screeners in this regard.
Fifteen patients with ACD from adhesives and diabetes devices were patch tested to different TBPs: BHQ 1% pet., TBC 0.25% pet., BHA 2% pet., BHT 2% pet., 4-tert-butylphenol (TBP) 1% pet. and 2,4-di-tert-butylphenol (di TBP) 1% pet. The culprit devices (medical adhesives, sanitary pads, diabetes devices) and TBP patch preparations were analysed using gas chromatography-mass spectrometry (GC-MS).
BHQ (9/13), TBC (7/13), and to a lesser extent BHT (3/15), BHA (2/15) and TBP (2/13) gave positive reactions. Seven patients had developed ACD from adhesives and diabetes devices, respectively, and one patient from sanitary pads. GC-MS analyses of the medical devices and patch test materials confirmed the presence of the patch-test positive TBPs, or chemically related derivatives, or, interestingly, tert-butylbenzoquinones (BBQ) were found, that is, spontaneously formed, highly reactive TBP metabolites, likely (pseudo-) cross reacting with the patch tested TBPs.
TBPs might be overlooked sensitizers in medical devices, and BHQ and TBC are potential screeners in this regard.
叔丁基苯酚（TBP）衍生物是胶粘剂和糖尿病设备中的抗氧化剂，可能引发过敏性接触性皮炎（ACD）。
本研究旨在报告医疗器械中 TBP 衍生物的致敏情况，并强调叔丁基对苯二酚（BHQ）和叔丁基邻苯二酚（TBC）在此方面是潜在的筛查剂。
对 15 名来自胶粘剂和糖尿病设备的 ACD 患者进行了不同 TBP 的斑贴试验：BHQ1% pet.、TBC0.25% pet.、BHA2% pet.、BHT2% pet.、4-叔丁基苯酚（TBP）1% pet.和 2,4-二叔丁基苯酚（di TBP）1% pet.。使用气相色谱-质谱联用（GC-MS）分析罪魁祸首设备（医用胶粘剂、卫生巾、糖尿病设备）和 TBP 贴剂制剂。
BHQ（9/13）、TBC（7/13），以及程度较轻的 BHT（3/15）、BHA（2/15）和 TBP（2/13）出现阳性反应。7 名患者分别因胶粘剂和糖尿病设备、1 名患者因卫生巾而发生 ACD。医疗器械和斑贴试验材料的 GC-MS 分析证实了阳性斑贴试验 TBP 或化学相关衍生物的存在，或者，有趣的是，发现了叔丁基苯醌（BBQ），即自发形成的、高反应性的 TBP 代谢物，可能（假性）与所测试的 TBP 发生交叉反应。
TBP 可能是医疗器械中被忽视的致敏原，BHQ 和 TBC 在此方面是潜在的筛查剂。
