Concentration and vehicle
Epoxy resin
Bisphenol A
1.0 % pet
Bisphenol F
0.25 % pet
Epichlorohydrin
Epoxy resin mixes
Diglycidyl ether of bisphenol A
No standard allergen
Diethylenetetramine
1 % pet
Triethylenetetramine
0.5 % pet
Acrylic resins
Acrylic acid
Tripropyleneglycol diacrylate (TPGDA)
0.1 % pet
Dipropylene glycol diacrylate (DPGDA)
0.1 % pet
Methacrylic acid
2-Hydroxyethyl methacrylate (2-HEMA)
2.0 % pet
Ethylene glycol dimethacrylate (EGDMA)
2.0 % pet
Hydroxypropyl methacrylate (2-HPMA)
2.0 % pet
Methyl methacrylate (MMA)
2.0 % pet
Triethylene glycol dimethacrylate (TREGDMA)
2.0 % pet
Tetrahydrofurfuryl methacrylate (THFMA)
2.0 % pet
Ethyl cyanoacrylate
10 % pet
Epoxy acrylates
2,2-bis[4-(2-Hydroxy-3-acryloxypropoxy)phenyl]-propane (bis-GA)
No standard allergen
2,2-bis[4-(2-Hydroxy-3-methacryloxypropoxy) phenyl]propane (bis-GMA)
2.0 % pet
2,2-bis[4-(Methacryl-oxyethoxy)phenyl] propane (bis-EMA)
2.0 % pet
2,2-bis[4-(Methacryloxy)phenyl]-propane (bis-MA)
2.0 % pet
Glycidyl methacrylate (GMA)
Colophony derivatives
Colophonium (rosin)
20 % pet
Abietic acid
10 % pet
Formaldehyde resins
Phenol-formaldehyde resin
1.0 % pet
Para-tertiary butylphenol formaldehyde resin
1.0 % pet
Para-tertiary butylphenol
1.0 % pet
Urea-formaldehyde resins
10 % pet
Melamine-formaldehyde resins
7.0 % pet
Toluene-sulfonamide formaldehyde resins
10 % pet
20.4 Management
The management of glue-induced dermatitis involves the identification of the irritants and allergens through detailed history and patch testing, avoidance of exposure and use of alternative allergen-free products, and finally treatment of skin inflammation using topical corticosteroids or other medications depending on the severity of the symptoms. For irritant contact dermatitis, restoration of the epidermal barrier is important.
20.5 Different Categories of Glue
20.5.1 Epoxy Resin Systems
Epoxy resin systems are composed of monomers such as bisphenol A and epichlorohydrin, curing agents or hardeners, reactive diluents, and several other additives such as fillers, pigments, plasticizers, and solvents. Most uncured epoxy resins are formed by the condensation of bisphenol A and epichlorohydrin. Hardeners, comprising of amines, amides, anhydrides, or inorganic compounds, are cross-linking agents for the resin that then lead to cured, hard, and insoluble products. Reactive diluents, mainly glycidyl ethers and sometimes glycidyl esters, are added to reduce viscosity and improve polymerization. About 75 % of epoxy resins used worldwide are based on diglycidyl ether of bisphenol A (DGEBA).
20.5.1.1 Use
Epoxy resins are used in the production of electrical and electronic devices; sport equipment manufacturing; construction industry; production of cars, ships, and airplanes; and glass fiber industry as well as the paint and glue industry. At home, epoxy adhesives are also used in a variety of manners for household projects. They are also used as high-performance adhesives in the construction industry.
20.5.1.2 Clinical Presentation
The clinical presentation of epoxy-induced dermatitis mainly involves the fingers, interdigital spaces, forearms, wrists, and to a lesser extent the face and the neck [16]. Facial dermatitis is more likely to occur due to epoxy resin hardeners which are more volatile than the resin.
20.5.1.3 Occupational Aspects and Use of Gloves
Epoxy resins are one of the main causes of occupational contact dermatitis [18]. Several reports describe epoxy sensitization to glues and bonding agents [17]. When fully cured, they do not cause contact allergy; however, any remaining monomers may induce sensitization or elicit allergic contact dermatitis.
Epoxy resins rapidly penetrate regular gloves, within minutes. Nitrile gloves are much less permeable to epoxies and should be used for personal protection when working with epoxy resins [27]. Standard industrial protective equipment such as thin body suits provides only short-term protection to epoxy penetration.
20.5.1.4 Main Sensitizers
The main sensitizer in the epoxy resin system is diglycidyl ether of bisphenol A (DGEBA) [31]. This epoxy resin is therefore included in the baselines series worldwide.
However, allergic contact dermatitis could also be due to hardeners, reactive diluents, or other epoxy resins (e.g., diglycidyl ether of bisphenol F) [18]. Patch testing with only DGEBA will miss other potential allergens. Therefore, it is important to obtain information about the individual ingredients of the specific epoxy resin system the patient has been exposed to.
Sensitization occurs mainly due to glycidyl ethers among several other reactive diluents. Among a large variety of epoxy hardeners, amines are the most potent sensitizers. On the other hand, contact dermatitis caused by bisphenol A and epichlorohydrin is rare. Irritant contact dermatitis may result from epoxy compounds, often from amine and anhydride hardeners, glycidyl ethers, benzol, toluol, and epichlorohydrin.
For patch testing of epoxy resin system, the components of the patient’s adhesive exposure should be taken into consideration, and several chemicals including hardeners, diluents, and non-DGEBA epoxy resins should be tested in addition to DGEBA. Bisphenol A and epichlorohydrin should also be included. Active sensitization has been reported during patch testing of epoxy chemicals [18, 19]. Epoxy allergens to consider for testing are summarized in Table 20.1.
20.5.2 Acrylic Resin
Acrylic resins are synthetic polymers derived from monomers such as acrylic acid, methacrylic acid, cyanoacrylic acid, and their esters (acrylates, methacrylates, and cyanoacrylates), acrylamides, and acrylonitrile. These polymers are used in a wide variety of products such as plastics, paint, artificial nails, and dental and orthopedic materials as well as in glues, adhesives, and sealants. Adhesives based on acrylates, methacrylates, and epoxy diacrylates include anaerobic sealants, ultraviolet-cured sealants, cyanoacrylates, methyl methacrylate, metal and glass glues, epoxy diacrylates (vinyl resins), and acrylic dental bonding material. Allergic and irritant contact dermatitis has been reported to many acrylic resins [6]. Gloves are not protective against acrylates since they rapidly penetrate through latex gloves [27].
20.5.2.1 Anaerobic Sealants
Anaerobic sealants are adhesives based on esters of acrylates and methacrylates that polymerize rapidly in the absence of air [23]. They also contain initiators, accelerators, and other additives. Anaerobic adhesives are mainly used in the manufacturing of machines, mechanical devices, and automotives. Contact allergy to anaerobic sealants has been reported [28]. The clinical presentation usually involves allergic contact dermatitis in the distal fingers. Anaerobic sealants mainly induce sensitization to aliphatic methacrylates; however, they may also induce sensitization to epoxy methacrylates (see “epoxy acrylates”) [3].
20.5.3 Cyanoacrylate-Based Glues
Cyanoacrylate-based glues (Krazy Glue, Super Glue) are used for binding biological materials such as human tissues and to seal wounds in surgery as well as adhesives for metal, rubber, glass, plastics, and textiles. Cyanoacrylates are rare sensitizers, although some cases have been reported [4]. Skin irritation is more common with cyanoacrylate-based glues compared to allergic reactions.
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