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Abstract Details

Allergic Contact Dermatitis to Silicone causing PAP Intolerance
Sleep
P1 - Poster Session 1 (9:00 AM-5:00 PM)
471

This is a rare case of allergic contact dermatitis to silicone, causing positive airway pressure (PAP) intolerance and refractory obstructive sleep apnea.
Silicones are extensively used in medical devices, as they are largely considered to be biologically inert. The majority of PAP masks have some portion made up of silicone. 
A 42-year-old man with a past medical history of morbid obesity and hypertension presented with excessive daytime sleepiness, snoring, and poor sleep quality.  
An in-lab overnight polysomnogram showed severe obstructive sleep apnea with an Apnea-Hypopnea Index of 81.8 events per hour and minimum oxygen saturation of 59%. There was no significant hypoventilation during the study. 
He later had a PAP titration study which showed that CPAP 17 cm of water treated his OSA effectively.
He initially tried a  nasal pillows mask but was later transitioned to a  full face mask for mouth venting in sleep. Within one month of using the full face mask, he developed a painful and scaly red rash, which initially started around the contact area of the mask but later spread around the head and later all over the body. Since then, he tried several other masks but always developed the rash within a day of using it. He even tried a silicone mask with a memory foam layer; however, he developed the dermatitis reaction. 
He was evaluated by dermatology and had patch testing, which revealed allergic contact dermatitis to silicone and propylene glycol. 
In the follow-up visit, he was advised to use a cloth-based mask and non-silicone hose to avoid dermatitis reaction to silicone. 
Allergic dermatitis reaction to silicon is extremely rare. Since silicone is widely used in PAP masks, sleep specialists should be aware of this reaction, and non-silicone alternatives should be considered. 
Authors/Disclosures
Subhendu Rath, MBBS (Virginia Commonwealth University)
PRESENTER 		Dr. Rath has nothing to disclose.
Neeraj Kaplish, MD The institution of Dr. Kaplish has received research support from NIH. Dr. Kaplish has received intellectual property interests from a discovery or technology relating to health care.