Pattern of patch test reactivity among patients with clinical diagnosis of contact dermatitis: A hospital-based study

Abstract

Introduction:The patterns of positive patch test in Nepal have not been defined so far. The aim of this study was to describe the patterns of patch test reactivity in suspected Allergic Contact Dermatitis (ACD) patients. Methods: This was a hospital based retrospective study performed to investigate patch test reactivity in patients with ACD from April, 2016 through October, 2016. The data of patients who underwent patch test during this period were extracted and analyzed. Results: A total of 35 patients were included in the study. Nineteen (54.3%) tested positive to either one or more allergens. Among them, 17 (89.4%) reacted positively to a single allergen. The following patterns of positives were seen: nickel sulfate, 5 (26.3%), fragrance mix 3 (15.7%), and parthenium 3 (15.7%). Cobalt sulfate, formaldehyde, potassium dichromate, benzocaine, nitrofurazone, chlorocresol each was positive in single patient. Majority of the patients were housewives (22.6%) followed by students and officers (13% each), farmers (10%), health care workers (9.7%), wet work (6.5%) and others (20). Less than half (45%) of the hand eczema showed positive patch test. Similarly,40% of the patient of scattered generalized dermatitis showed reactivity to parthenium, nickel sulfate and multiple antigens. Conclusions: The most common allergens identified were nickel sulfate, fragrance mix and parthenium. Since, there is no well defined contact allergen in the Nepalese community, so patch test kits developed elsewhere might not have been beneficial and calls for need of large scale investigation to identify the local allergens.

Patch Testing In Nepalese Population: A Single Center Study From Kathmandu, Nepal

“…Similarly, some studies got even higher sensi za on than noted by Parajuli et al; Sharma VK et al 1998 (65.5%) and VK Sharma et al 2004 (63.6%). 5,9,10 The most common pa ern was the hand eczemas, which was similar to the fi ndings of Parajuli et al (2017), Agrup G 1969, Goh C L 1989 and Holness D L et al 1995. 5,[11][12][13] This was in contrast to Indian studies which showed air borne contact derma s as being the commonest type of eczema.…”

“…7,8 But contrary fi nding was found in study conducted in Nepal by Parajuli et al (2017) which showed a higher allergic reac on (54.3%). 5 The discrepancy might be due to their small sample size (35 pa ents). Similarly, some studies got even higher sensi za on than noted by Parajuli et al; Sharma VK et al 1998 (65.5%) and VK Sharma et al 2004 (63.6%).…”

“…4 It has been found that rapid urbaniza on has led to exposure and subsequent sensi za on of Nepalese popula on to many allergens. 5 This has increased the importance of patch tes ng in Nepal as well.…”

Hand eczema and patch testing – A clinico-allergiological study

“…In most of the cases it is not possible to identify the cause as irritant or allergic. So, patch testing becomes an important diagnostic tool for identification of the allergen or allergens responsible for eczema [5,6].…”

A nice stratagem to treat poikiloderma of Civatte, evoked by fragrances and essential oils, by means of a resin that is commonly employed to fifi nish mandolins and Maggiolini’s furniture

“…Fragrances are found in many cosmetics, as well as more traditionally in perfume or cologne form. Fragrances, including fragrance mix, balsam of Peru, and cinnamic aldehyde are the most commonly identified allergens in cosmetic-induced ACD [2,3].…”