Cell phone screen protector triggers allergic contact dermatitis

Key takeaways:

• A woman presented with a rash on the left side of her face and on her fingers.
• Patch testing revealed sensitivities to acrylates.
• The pattern suggested that her screen protector was the trigger.

ANAHEIM, Calif. — A woman who used an acrylate screen protector on her cell phone developed a rash on her face and fingers, according to a poster presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

“This is something that’s not commonly seen, but it may be something that’s been missed,” Mohammad A. Younus, MD, allergist and immunologist, Center for Allergy, Asthma and Immune Disorders, Hackensack University Medical Center, told Healio.

“We really don’t think about acrylates and screen protectors,” he continued.

In 2019, the woman, age 50 years, experienced repeated onset of contact dermatitis. She was sensitive to ethyl acrylate, ethyl cyanoacrylate, methyl acrylate, methyldibromo glutaronitrile and phenoxyethanol/Euxyl K 400 based on allergy patch testing.

In April 2022, she visited the ED with itching, erythema and vesicles mainly on the left side of her face, ear and arm. She received a 5-day prescription for prednisone, diphenhydramine and oral cephalexin.

Later that month, her left ear, face and neck developed erythematous and pruritic rashes. She was prescribed desonide, triamcinolone 0.1%, cetirizine and a 9-day prednisone course in addition to oral cefadroxil for a soft tissue infection on her neck. Tacrolimus 0.1% was used to treat skin damage on her thumbs and forearms as well.

Response to topical and systemic corticosteroids was good, the researchers wrote.

Additional allergy patch testing in September 2022 produced extreme positive reactions to ethyl acrylate, methyl methacrylate and 2-hydroxyethyl methacrylate.

In August 2023, the patient developed a pruritic rash on her neck that was getting worse. When the authors evaluated potential contact sources, the patient reported using her phone with her left hand frequently, correlating with the distribution of the rash.

“Phones are something that we use on a constant basis,” Younus said. “The distribution of her rash made us believe that was probably likely occurring.”

The physicians diagnosed her with allergic contact dermatitis, suspecting that repeated exposure to the acrylates in the phone’s screen protector triggered these reactions.

Treatment with triamcinolone ointment, a 3-day course of prednisone and cetirizine as needed followed with good response, the authors said. The patient also was advised to strictly avoid acrylates and any products that included ingredients that provoked the positive patch test results.

Since avoiding acrylic phone screen protectors, the authors said, the patient has not had any new cutaneous lesions.

“That was the main culprit,” Younus said.

The authors noted that acrylate contact dermatitis (ACD) affects approximately 72 million Americans each year, with greater prevalence among women.

Considering the ubiquity of phone use and this prevalence of ACD, the authors called for greater awareness of the materials used in everyday products and urged manufacturers to label products that may include potential allergens.

Also, the authors urged health care professionals to consider acrylates as possible allergens when diagnosing unexplained contact dermatitis and to educate patients about hidden sources of allergens.

Consumers should be more proactive in understanding the materials in the products they use as well, the authors continued, particularly consumers who have a known history of sensitivities.

“It’s something that we need to keep in mind,” Younus said. “Screen protectors are very commonly used.”

Acrylates can be found in any plastic products, Younus continued, in addition to adhesives, sealants, coatings and cosmetics. Many patients have hand or eyelid dermatitis from acrylates on fingernails, he added.

“This patient didn’t really have any fingernail acrylate exposure. It was mainly just the screen protector,” Younus said. “That’s what makes this case so unique.”