Diagnosis: Allergic Contact Dermatitis form Acrylate glue (from artificial fingernails)
This 30-year-old woman was seen in consultation at one of the Twin Cities’ hospitals for exquisitely painful fingertips. To control the pain on a self-administered/controlled morphine drip and the equivalent of 80 mg of oral prednisone daily. She had had a “cosmetic treatment” done to her fingers shortly before the problem erupted.
Diagnosis: Allergic contact dermatitis secondary to acrylate glue from artificial fingernails. This patient had an impressive allergic contact reaction to acrylate glue. Because the glue was underneath her artificial nails, they had to be removed and the pain was so intense that even with the use of morphine, the removal of the nails caused such great pain, the patient had to undergo a general anesthesia for the artificial nail removal. The patient was treated with a self-administered/controlled morphine drip and prednisone for approximately two weeks. She did quite well but emphatically stated she will never use artificial fingernails again. It is also important to note that she was also instructed on the avoidance of other acrylate containing products, items such as Crazy Glue, etc. For additional information on allergic contact dermatitis in general, please see the CME article below.