scholarly journals Role of footwear allergens in juvenile plantar dermatosis

Author(s):  
Shyni Perumbil ◽  
Kunnummal Muhammed ◽  
Sarita Sasidharan Pillai

<p class="abstract"><strong>Background:</strong> Juvenile plantar dermatosis (JPD) is characterized by shiny dry fissured dermatitis of the plantar surface of the foot, affecting children aged 3-14years. The most accepted theory is that JPD is a frictional contact dermatitis of the forefoot in which atopics are more prone to develop. Allergic contact dermatitis remains a close differential diagnosis; it can aggravate the predisposing JPD. In this background we carried out a study among children aged fourteen years and below with clinically diagnosed JPD to know the age and sex profile, aggravating factors and clinical features in this part of the country<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> All children aged 14 years and below with JPD attending our outpatient department from November 2006 to November 2007 were included in this study. Using a preset proforma, data regarding age and sex, information on any relation to footwear, past history of allergic disorders in person or family members was collected. All the 40 patients were patch tested using the footwear allergen series in petrolatum base. Patch test unit was removed after 48hours and the results were interpreted using criteria laid down by International Contact Dermatitis Group (ICDRG). The data was analyzed and made an attempt to understand the role of footwear allergy in JPD.</p><p class="abstract"><strong>Results:</strong> 22 girls and 18 boys attended our OPD with JPD between the age group of 4-14 years. 52.5% were using footwear made of plastic; 25%used leather; 12.5% rubber footwear. Patients presented with erythema and glazed appearance of foot along with fissuring. The areas of involvement were distal soles and toes in 70%, distal sole alone in 7.5% and distal sole and dorsum of toes in 22.5% of patients. Personal history of atopy was documented in 15% of patients and family history of atopy was present in 20% of cases. 20% of patients complained of exacerbation with footwear. Of the 40 patients who underwent patch testing, 10% only showed <span lang="EN-IN">positive patch test reaction mainly to potassium dichromate (5%). </span></p><p class="abstract"><strong>Conclusions:</strong> JPD is not an uncommon disease and it predominantly affects school going children. Seasonal variation was associated with aggravation of disease. Specific footwear was identified to cause flare ups in a significant percentage of study population (20%) and this was proven by patch test results in half of them. Though nearly one fifth of the affected had an atopic diathesis in person or family, the present data suggests that JPD is not exclusive to atopics. A large sized study is required to <span lang="EN-IN">evaluate the role of footwear in JPD.</span></p>

2019 ◽  
Vol 7 (2) ◽  
pp. 204-207 ◽  
Author(s):  
Phuong Pham Thi Minh ◽  
Trang Thi Minh ◽  
Doanh Le Huu ◽  
Thuong Nguyen Van ◽  
Sau Nguyen Huu ◽  
...  

BACKGROUND: Hand eczema is a common chronic and relapsing skin disease with various clinical features. Hand eczema aetiology can be allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), atopic dermatitis (AD) and unknown or combination causes. If the causative agents are not detected treatment of hand eczema will be a failure. A patch test can be useful to detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema. In Vietnam, patch test has not been used before, so we conduct this study. AIM: To identify causative allergens by using patch test with 28 standard allergens in consecutive patients. METHODS: A group of 300 HE patients from the National Hospital of Dermatology and Venereology (NHDV) in Vietnam were enrolled in this study. They were divided into 4 groups-ACD, ICD, AD and unknown aetiology. The patient was patch tested with 28 standard allergens to identify the causative agents. RESULTS: Among the 300 HE enrolled patients, ACD accounted for 72.7%, AD and ICD had the same rate of 12.7%. 39.3% of the patients had a positive patch test. Reaction to nickel sulfate was the most common (10.3%), followed by potassium dichromate (9.7%), cobalt (4%) and fragrance mix (3.1%). About one-third of the cases had relevant clinical reactions correlated with the contact agents and clinical history. Males reacted to cement, thiuram mix and formaldehyde more than females, while females reacted to a nickel more than males. CONCLUSIONS: Hand eczema has variable clinical features and diverse aetiology. ACD is an important cause of hand eczema that can be managed with a patch test to detect causative allergens. Nearly 40% of HE cases had positive patch test. Relevant patch test reactions were seen in one-third of the patients. We propose using patch test detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema.


2022 ◽  
Vol 1 ◽  
pp. 17-20
Author(s):  
Trupti Desale ◽  
Abhishek De ◽  
S. K. Shahriar Ahmed ◽  
Aarti Sarda ◽  
Kiran Godse ◽  
...  

Objectives: Chronic spontaneous urticaria (CSU) is defined as short lived (< 24h) wheals occurring spontaneously without any triggering factors, daily or almost daily for at least 6 weeks. Though CSU is mainly a Type 1 hypersensitivity reaction, earlier studies suggested contact allergy may have some role to play an important role in the etiopathogenesis of CSU. The objective of the study is to find out the relevance of patch test in the etiopathogenesis of and its correlation with serum IgE level. Materials and Methods: Thirty-one patients of CSU were thoroughly evaluated for clinical and laboratory parameters. We conducted patch testing with Indian Standard Series (ISS) in all of them and tried to find out the relevance of every positive reaction. Relevant positive cases were asked to avoid exposure for 2 months and were maintained only in breakthrough antihistamines. Furthermore, correlation of positive patch test reaction with high IgE and eosinophil count were studied. Results: Seventeen (55%) cases came positive for patch test. Potassium dichromate, lanolin, benzocaine, and fragrance mix were the most common offenders. Patients with very high IgE count had patch test positivity with multiple allergens. Seven of the fifteen patients who had relevant positive patch results could be followed up to remission; three were lost to follow-up. Conclusion: Patch test with ISS may give important clue to in a subset of patients of CSU and thus may be considered an important part of routine investigations of CSU.


2018 ◽  
Vol 22 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Mark G. Kirchhof ◽  
Gillian C. de Gannes

Background: Atopy is a genetic predisposition to the development of allergic reactions and the increased production of immunoglobulin E (IgE) upon exposure to environmental antigens. Clinical manifestations of atopy include asthma, atopic dermatitis (AD), and allergic rhinoconjunctivitis (ARC). Objective: To determine if cutaneous delayed hypersensitivity reactions (CDHRs) as assessed by patch testing are higher among patients with a history of atopy and with a familial predisposition to atopy. Methods: For this study, we reviewed the patch test database of the UBC Contact Dermatitis Clinic over a 4-year time span. A personal history of asthma, AD, and ARC was recorded. In addition, a family history was obtained and manifestations of atopy in family members were noted. Results: A total of 1515 patients were included in this study. Our data show that the odds ratio (OR) of a positive patch test with a personal history of atopy was 1.39, while the OR of a positive patch test with a family history of atopy was 1.69. Conversely, a personal history of respiratory atopy did not significantly affect the probability of a positive patch test, with an OR of 1.03. Conclusion: We conclude from our study that patients with a personal or family history of atopy have an increased risk of allergic contact dermatitis (ACD). These results provide further evidence for the link between atopy and ACD and suggest that children of atopic parents should avoid potential contact allergens and would likely benefit from prophylactic emollient use.


2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Thacharamban Mansoorali ◽  
Abdulsalam Sarin

Objectives: The objective of the study was to identify the allergens showing positive patch test reaction (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis (CD) to cement attending a tertiary referral center. Materials and Methods: We included cement workers with clinically diagnosed allergic CD to cement who attended the dermatology outpatient clinic of our tertiary referral center from January 2013 to December 2013. We did patch testing in all the cases ( after subsidence of active dermatitis) with Indian standard battery of patch test allergens and documented the allergens that showed a positive reaction. Results: Forty-seven (94%) of the 50 study participants showed a positive reaction to one or more of the allergens. The most common allergen that showed a positive reaction was potassium dichromate (43/50, 86%). Twenty-five patients (50%) showed positive reactions to more than 1 allergen. Four patients (8%) showed positive reactions only to allergens that were not seen in cement. Limitations: Small sample size and lack of information on clinical response of dermatitis to avoidance of identified allergen were the major limitations. Conclusion: Twenty-five (50%) patients showing positive reactions to more than 1 allergen tested and 4 (8%) showing positive patch test reaction to none of the allergens in cement (but to other allergens) highlight the role of patch testing in identifying the probable allergens in patients with clinically diagnosed allergic CD to cement.


2019 ◽  
Vol 11 ◽  
pp. 117863451988055
Author(s):  
Eman Omar Khashaba ◽  
Mohammad A Gaballah ◽  
Ahmed Fathy State ◽  
Mona Elwassefy

Objectives: First, this research was instituted to identify common allergens, and second, to test the association between IL16 gene promoter polymorphism rs4778889 T/C and allergic contact dermatitis (ACD). Methods: A case control study was conducted in dermatology outpatients’ clinic. Study subjects received interview-based semi-structured questionnaire, complete skin examination, IL16 gene promoter was investigated by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis, and IQ Ultra™ patch test units (Chemotechnique Diagnostics AB, Sweden) with 10 substances were used. Results: Most of the prevalent cases had positive patch test (93.3%). The most common clinical presentation of ACD in our patients was itching (96.7%), followed by dryness (86.75%), erythema (76.7%), and fissuring (76.7%). There was higher CC gene distribution among cases, but there was no statistically significant difference. IL16 gene distribution was nearly similar among different clinical presentations. Formaldehyde showed statistically significant higher frequency for CC. The most common allergen found was mercury chloride (76.6%), followed by potassium dichromate (26.6%) and cobalt chloride (20%). Conclusions: The current study found prominent metal sensitization (mercury chloride) over the previously known potassium dichromate. There was no statistically significant IL16 gene distribution among cases compared with control. However, C allele was more frequently encountered in cases. Further studies are required to test the association with IL16 genotype and ACD and highlight the new trends in metal sensitization among cement-exposed workers.


Author(s):  
Ashok S. Hogade ◽  
P. Anusha

<p class="abstract"><strong>Background:</strong> Hand eczema is a common distressing condition in different occupational groups caused by various endogenous and exogenous factors. It appears to be the most common occupational skin disease, comprising 80% or more of all occupational contact dermatitis. Patch test at present is the only scientific method to diagnose the contact allergen and in subsequent management of patient.</p><p class="abstract"><strong>Methods:</strong> An observational study of patch test was conducted on 100 patients of hand eczema in the department of DVL, Basaveshwara Teaching and General Hospital, Kalaburagi. After detailed history and complete examination, patch testing was done using Indian Standard Series and graded by International Contact Dermatitis Research Group criteria at 48 hours and 72 hours.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 100 patients, there were 28 females and 72 males. The commonest age group seen was 20-40 years followed by 40-60 years. Commonest sensitizers were to potassium dichromate (34%) followed by nickel (18.7%), Parthenium (12.5%), PPD (7.8%), other (26%). Out of 64 patients who were positive, 82.8% were positive to single allergen, 10% to two allergens and 6.2% to multiple allergens.</p><p class="abstract"><strong>Conclusions:</strong> Patch test is considered as gold standard method for diagnosis of allergic contact dermatitis and thus preventing the morbidity of repeated episodes of eczema.</p>


2021 ◽  
pp. 20-22
Author(s):  
SivaKumar Sivasubramaniam ◽  
Ambujam Govindasamy ◽  
Kode Leela Sravanthi ◽  
Brindha Pandiyan

Introduction: Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on day-to-day basis. Patch testing is a reliable method for detecting the causative antigens in suspected cases. Aims And Objectives: To assess the demographic profile, pattern of ACD, and patch test profile of suspected cases of ACD attending contact dermatitis clinic of our department. Materials And Methods: It was a prospective study in which all the patients with suspected ACD attending OPD of department of dermatology over a 3 month period were analysed. Patch testing was done using the most common antigens primarily, and other batteries were used depending on patient requirement and availability. Results: A total of 50 patients were enrolled in the contact dermatitis clinic over a period of 3 months. Hand eczema was the most common pattern seen in 23 cases followed by feet eczema, hand and foot eczema, facial eczema, forearm and leg eczema and photoallergic contact eczema. A total of 32 (64%) gave positive patch test results, with nickel sulfate being the most common allergen identified followed by cobalt sulfate & potassium dichromate. Conclusion: Common allergens identified in our study were more or less similar to studies from other parts of India


2014 ◽  
Vol 18 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Katie Beleznay ◽  
Gillian de Gannes ◽  
Sunil Kalia

Background: As the use of sunscreens becomes more prevalent, reports of adverse effects to sunscreens have increased. Objective: To analyze a patch test database for the prevalence of allergic contact dermatitis (ACD) to sunscreen. Methods: The database was searched for positive patch test reactions to benzophenone-3. Charts were also reviewed for those who were further tested to the sunscreen series. Results: Twenty-three of the 1,527 patients seen were tested to the sunscreen series. Of these, only 4 patients had a positive reaction to a sunscreen chemical or to the product they were using. In addition, 8 of the 1,527 patients who had no specific history of sunscreen allergy reacted to benzophenone-3. Conclusion: ACD to sunscreen was found to be very uncommon (0.8%). Other final diagnoses included ACD to excipients such as fragrances or preservatives and suspected photosensitive disorders.


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