Q:

5/8/2012
I saw a patient in consolation today that had a previous allergic reaction to her contacts and was told she had a "silicone allergy". She has been tested to latex which was negative and now she is wants to schedule breast implants. Is there a protocol to test to silicone?

A:

Thank you for your inquiry.

There have been published reports of contact dermatitis to silicone diagnosed by patch testing (see two references and one abstract below). However, to the best of my knowledge, there is no commercially available patch test for silicone. At least I could not find such on a literature search.

However, as you can see from one of the articles below, the company provided silicone for patch testing in one instance, and you might contact the manufacturer of the silicone implant for a sample to use for patch tests prior to surgery.

In addition, you could do the same for the contact lens that was used. Also, some companies offer to produce a patch test kit for a chemical not contained in their standard testing (Dormer Labs).

However, unfortunately, as best I can tell, there is no well-standardized patch test procedure for silicone. I was unable to find one in the literature. Therefore, the results of testing might be open to question.

Thank you again for your inquiry and we hope this response is helpful to you.

The Laryngoscope. Volume 115, Issue 10,pages 1760–1762, October 2005.

Otolaryngol Head Neck Surg December 1995; vol. 113 no. 6 782-784.

Ann Thorac Surg. 2009 Apr; 87(4):1275-7. Allergy to pacemaker silicone compounds: recognition and surgical management. Oprea ML, Schnöring H, Sachweh JS, Ott H, Biertz J, Vazquez-Jimenez JF.
Source
Department of Pediatric Cardiac Surgery, RWTH Aachen University, Aachen, Germany.
Abstract
Silicone is a widely used biomaterial. Contact allergy, particularly to silicone components of pacemaker coatings, is uncommon. We present a 12-year-old girl with a history of complex congenital heart disease and acquired complete heart block excluding transvenous lead placement. Contact allergy to silicone led to multiple surgical interventions until the etiology for recurrent pacemaker wound complications was discovered. The key to diagnosis was a specific manufacturer's patch test. Complete removal of the former pacing system and placement of custom-made silicone free pacemaker components and epicardial use of silicone free transvenous leads were essential for successful therapy.

Sincerely,
Phil Lieberman, M.D.

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