Patch testing in patients with suspected footwear dermatitis: A retrospective study

Abstract

Background:Footwear dermatitis represents a common but often undiagnosed or misdiagnosed condition. Patch testing aids in its confirmation and identification of the offending allergen.Aims:This study aimed to find the frequency of positive patch test reactions in cases with suspected allergic contact dermatitis (ACD) to footwear, as well as the common responsible allergens.Materials and Methods:This is a retrospective record based study of 37 patients, with suspected ACD to footwear, who underwent patch testing with Indian standard series and Indian footwear series from July 2012 to July 2015.Results:The majority of patients (45.94%) belonged to the age group of 20–40 years. Dorsal aspects of feet (81.08%) and soles (18.92%) were the common sites involved. Patch test was positive in 18.92% patients. The most common causative allergens were hydroquinone monobenzylether (8.11%) and 4-aminoazobenzene (5.41%).Conclusion:Common chemicals implicated in ACD were rubber, rubber additives, and dyes. The principal culprit allergens were hydroquinone monobenzylether and 4-aminoazobenzene.

The Value of Patch Testing With Shoe Material Samples in Patients Suspected of Shoe Allergic Contact Dermatitis

“…This can be attributed to the wearing of tight-fitting business shoes, resulting in pressure and friction being experienced for extended periods. The most frequent site of lesion observed in this study was dorsal of feet (70.1%), the same as that observed in previous studies, 13–15 probably due to the large surface area, thin stratum corneum, and prolonged closed contact with the upper part of the shoes 10…”

“…33 There were some previous reports of positive patch testing to those additional allergens from commercially available shoe series. 3,4,14,15,19,20,34 Among those allergens, the most frequently found was 4,4-dithiodimorpholine, a rubber accelerator; however, only 8 cases were reported. 34 Although patch testing with a specific shoe series helps to detect the culprit allergens, it may be difficult for patients to obtain the actual ingredients used to make the shoes and practically avoid the allergen.…”

Patch test results of 276 cases with footwear dermatitis - A retrospective study from a tertiary care centre in South India

“…Re-dying of leather shoes is more harmful, as there is more chance of leakage of chemicals leading to allergy. [ 2 ]…”

“…They found rubber, as the most common material in Indian footwear, to be the cause of allergy. [ 2 ] In a study be Suhail et al ., 66% patients showed positive patch test results. Rubber chemicals were the commonest allergen and among the rubber chemicals, the main offending allergen was carba mix as overall 26% patients were sensitive and 16% patients were sensitive to agents used in tanning the leather.…”

“…Patch testing, interpreted with clinical relevance is the most useful method for diagnosing footwear dermatitis. [ 2 ] Educating about the avoidance of allergen and providing suitable alternatives are very important in the management of footwear dermatitis. We did this study to find the common allergens in footwear, causing allergic contact dermatitis (ACD), by retrospective analysis of the data of the patients who had undergone patch testing with footwear series, approved by the Contact and Occupational Dermatoses Forum of India (CODFI).…”