Triphenylguanidine, a new (old?) rubber accelerator detected in surgical gloves that may cause allergic contact dermatitis

Abstract

Background: Rubber accelerators are common contact allergens in healthcare personnel, owing to exposures from medical gloves.

Objectives: To analyse glove extracts used for patch testing for the presence of guanidine-type accelerators, and to describe the results of patch testing with triphenylguanidine (TPG) in 2 cases of contact allergy and with TPG added to the rubber series.

Materials and methods: Gas chromatography-mass spectrometry and liquid chromatography with ultraviolet detection were used for analysis of glove extracts. Patch tests were performed with guanidine accelerators detected in the extracts.

Results: TPG, an accelerator not previously reported as being present in rubber gloves, was found in the glove extracts. Patch testing with TPG showed relevant contact allergic reactions in patients with hand dermatitis caused by rubber gloves.

Conclusions: Chemical analysis of extracts for patch testing is important in the identification of new possible allergens. In this case, a rubber accelerator previously not reported as a possible contact allergen was found in extracts of surgical gloves.

Keywords: GC-MS; accelerator; allergic contact dermatitis; diphenylguanidine; glove; rubber; triphenylguanidine.