INTRODUCTION: Closure System uses n-butyl-2-cyanoacrylate for minimally invasive treatment of chronic venous disease. While generally safe, reported adverse events include phlebitis, hypersensitivity, foreign body granulomas, and endovenous glue-induced thrombosis. Specifically, hypersensitivity reactions have been reported in 6.3%-13% of patients. METHODS: We present 4 patients with heterogeneous cutaneous and systemic reactions following CAC, ranging from localized nodules to erythroderma. Diagnostic evaluation included patch testing, ultrasound, CT, and histopathology, with varying findings for each case. RESULTS: Consequently, treatments ranged from intralesional corticosteroids to prolonged systemic corticosteroids and surgical excision. CONCLUSION: This case series highlights the limitations of patch testing, the importance of considering imaging and biopsy for diagnosis, and the need for individualized management strategies.
Shah et al. (Mon,) studied this question.