Contact Dermatitis From Gum Mastic (Pistacia lentiscus) and Gum Storax (Liquidambar styraciflua) in Mastisol-Allergic Patients

Dermatitis. 2021 Nov-Dec;32(6):430-436. doi: 10.1097/DER.0000000000000702.

Abstract

Background: Mastisol Liquid Adhesive is widely used on the skin, especially after surgical procedures. It contains gum mastic, gum storax, methyl salicylate, and ethanol.

Objective: The aims of the study were to review our experience patch testing patients allergic to Mastisol and to assess coreacting substances.

Methods: We identified 18 patients who were allergic to Mastisol. Most of these had a history of postoperative or cardiac electrode dermatitis and underwent patch testing with multiple surgically related substances, including ingredients of Mastisol, compound tincture of benzoin, and fragrance-related ingredients and botanicals.

Results and conclusions: Among Mastisol-allergic patients, 13 (72%) of 18 were allergic to gum mastic, whereas 7 (44%) of 16 were allergic to gum storax. There was frequent coreactivity with various fragrance-related materials, including Majantol, Styrax benzoin, Myroxylon balsamum, Myroxylon pereirae, propolis, and others. Two gum mastic-allergic patients had positive patch tests with hydroperoxides of linalool and several other linalool-containing essential oils. As gum mastic contains linalool, it may explain some gum mastic reactions. Among patients without a history of postoperative contact dermatitis, 1 (0.4%) of 250 was patch test positive for gum mastic. This patient had allergic contact dermatitis from fragrances, so the gum mastic reaction was likely a true-positive relevant reaction.

MeSH terms

  • Dermatitis, Allergic Contact / etiology*
  • Female
  • Humans
  • Liquidambar / genetics*
  • Male
  • Mastic Resin / adverse effects*
  • Middle Aged
  • Pistacia / chemistry*
  • Plant Extracts / adverse effects*

Substances

  • Mastic Resin
  • Plant Extracts