key: cord-0793848-ez3wv1fz
authors: Garrido, Pedro Miguel; Alpalhão, Miguel; Correia, Teresa; Filipe, Paulo
title: Allergic contact dermatitis caused by elastic bands of an N95 mask
date: 2022-03-25
journal: Contact Dermatitis
DOI: 10.1111/cod.14100
sha: 19ddbdb839b34c15657d0b6cc5105ed12d4313ad
doc_id: 793848
cord_uid: ez3wv1fz

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After the sensitivity to the textile dye mix Mx-30 was found with patch testing, the patient was questioned in detail and reported contact hypersensitivity to green clothes, including her nursing uniform.

Additional patch tests were then performed with a textile dye series (Chemotechnique Diagnostics). Positive reactions to disperse yellow 3 (++) and disperse blue 106 (+) were identified on D2 and D4.

A diagnosis of allergic contact dermatitis (ACD) to the elastic bands of the 3M Aura 9320+ N95 mask was made.

The patient was prescribed methylprednisolone aceponate 0.1% cream b.i.d. for 5 days and masks were changed to a type with cotton cloth bands, with resolution of complaints. She was also advised to avoid wearing green clothes.

Personal protective equipment is essential to the safety of health care workers. In particular, N95 masks are recommended for the protection of health care workers who are providing direct patient care or working within the zone for individuals with suspected or confirmed COVID-19 infection. Prolonged wear of facial protective equipment can lead to occupational dermatoses. 1 However, few cases of N95 mask-associated ACD have been reported, despite their generalized wear during the COVID-19 pandemic. 2 The main allergens involved in ACD to the elastic bands from N95 masks are the rubber additives thiurams and dithiocarbamates. 3 We were unable to clarify the role of benzothiazole compounds and textile dyes in the presented case of ACD from elastic bands of an N95 mask. It has not been possible to obtain further information about the constituents of the N95 masks from the manufacturers, and no laboratory analysis of the elastic bands was performed. Nevertheless, benzothiazole compounds are well-known vulcanization accelerators of polyisoprene, the main material in the elastic bands of the 3M Aura 9320+ N95 mask. Therefore, these allergens may have a relevant role in this case of ACD.

Of interest, only one of the two masks with blue elastic bands elicited a positive reaction. ACD in response to textile dyes in masks is scarcely reported in the literature. Recently a case of contact vitiligo was described in a patient with delayed hypersensitivity to disperse blue in surgical blue masks. 4 In conclusion, ACD from N95 mask components in health care workers can be severe, given the prolonged and continuous contact with the source of allergens. Therefore, identification of the allergens is crucial to adapt personal protective equipment, avoiding potential decrease in work performance and quality in life.

Skin reactions of N95 masks and medial masks among health-care personnel: a self-report questionnaire survey in China

Occupational dermatitis to facial personal protective equipment in health care workers: a systematic review

Allergic contact dermatitis caused by elastic bands from FFP2 mask

White reaction to blue": a contact vitiligo due to disperse blue in surgical mask

Allergic contact dermatitis caused by elastic bands of an N95 mask

The authors declare not having any conflict of interests.The authors received no financial support for the authorship and/or publication of this article.The patient has consented to the submission of the case report to the journal.

https://orcid.org/0000-0002-1048-3056Miguel Alpalhão https://orcid.org/0000-0001-7672-0395