2‐Cyanoethyl dimethyldithiocarbamate, a new contact allergen found in accelerator‐free nitrile gloves
Linda Ljungberg Silic, Christina Persson, Maria Pesonen, Katri Suuronen, Cecilia Svedman, Ola Bergendorff- Dermatology
- Immunology and Allergy
Abstract
Background
Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator‐free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them.
Objectives
To identify and chemically characterize a new allergen, 2‐cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC.
Methods
The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High‐performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2.
Results
CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC.
Conclusions
CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.