scholarly journals Clinical evaluation and role of patch testing in identifying the exogenous causes in patients presenting with hand eczema

2019 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
S. Jyothi Lakshmi ◽  
K. Gopalakrishnan
Keyword(s):  
Patch Test ◽  
Patch Testing ◽  
Potassium Dichromate ◽  
Morphological Type ◽  
Cross Sectional Study ◽  
Hand Eczema ◽  
Cross Sectional ◽  
Positive Patch Test ◽  
Male Preponderance ◽  
Epidemiological Characteristics

<p class="abstract"><strong>Background:</strong> Hand eczema is a common dermatological problem resulting from both allergic and irritant contactants. Patch testing helps in both diagnosing and identifying allergens.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study wherein 110 patients with hand eczema attending Dermatology OPD were included and patch testing was done. Data was collected from April 2015 to July 2016 and was analysed for clinical and epidemiological characteristics.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients studied was 40.27 years with male preponderance. Housewives were the major occupational group comprising 25.5% followed by masons 21.8% and farmers 10.9%. The commonest morphological type was hyperkeratotic type constituting 51.85%, followed by fingertip eczema 19.1%, discoid eczema 11.8%, wear and tear dermatitis 8.2%, recurrent focal palmar peeling 4.5% and pompholyx 4.5%. In the study group 60% of patients showed positive patch test result. A total 66 patients showed patch test positivity to a total of 69 allergens. Nickel was the most common allergen 27.3% identified followed by potassium dichromate 10.9%. Among female patients with positive patch test 70% reacted to nickel and similarly 83.5% of male patients reacted to potassium dichromate. Parthenium allergy was seen in 41.5% of farmers studied.</p><p class="abstract"><strong>Conclusions:</strong> Patch testing has a definitive role in diagnosing hand eczema caused by allergens. Identifying the allergen involved helps the clinician in advising the patient regarding further avoidance of contactants.</p>

scholarly journals Patch testing in hand eczema: a cross-sectional study from a teaching hospital of North India

2018 ◽  
Vol 6 (2) ◽  
pp. 567 ◽  
Author(s):  
Seema Qayoom ◽  
Suhail R. Rather ◽  
Kafeel Khan
Keyword(s):  
Patch Testing ◽  
Potassium Dichromate ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Hand Eczema ◽  
Vital Role ◽  
North India ◽  
Nickel Sulphate ◽  
Cross Sectional ◽  
Female Ratio

Background: Hand eczema is a common dermatological disorder in different occupational groups with multifactorial etiology. Patch Testing serves as an important tool for identifying responsible allergens.Methods: The study was conducted in the Department of Dermatology, SKIMS-MCH, Srinagar for duration of one year from June 2016 to June 2017. Patients of either gender with hand eczema, aged 18 years and above, presenting to outpatient department were enrolled in the study. After taking informed written consent from patients, a detailed history was taken, and clinical examination was performed on first visit. Patch testing with Indian Standard Series was performed a fortnight after complete resolution of signs and symptoms of eczema and after complete withdrawal of the drugs.Results: Out of 116 patients 60 (51.7%) were males and 56 (48.3%) were females. Male to female ratio was 1.07:1. Mean age of presentation of females was 35.42±12.52years and of males was 49.2±10.01years. The commonest allergen was Nickel sulphate (23.2%) followed by Potassium dichromate (15.1%). Nickel sulphate was most common allergen in females while Cobalt sulphate and Paraphenylene diamine were most common allergens in males. House wives (36.2%) and farmers (11.2%) were occupations with high frequency of hand eczema.Conclusions: Patch testing in clinically diagnosed cases of hand eczema can play a vital role in not just the confirmation of the label but can also reduce the socio-economic burden on such patients.

scholarly journals Impact of Patch Testing on Quality of Life in Patients with Hand Eczema: A Follow-up Study

2015 ◽  
Vol 11 (3) ◽  
pp. 216-220 ◽  
Author(s):  
S Agrawal ◽  
A Rijal ◽  
S Bhattarai
Keyword(s):  
Quality Of Life ◽  
Patch Test ◽  
Patch Testing ◽  
Life Quality ◽  
Hand Eczema ◽  
Patch Tests ◽  
Positive Patch Test ◽  
Sum Score ◽  
The Impact

Background Patch testing has previously been shown to influence the quality of life, although a very few studies have shown if this is dependent on the result of the patch tests. Objective To assess the impact of patch testing on the quality of life (QOL) in patients with hand eczema (HE). Methods A total of 50 patients diagnosed of hand eczema at the time of patch testing, aged 16 years and above participated in this study. Detailed demographic information and diagnosis of hand eczema were collected on the day of the patch test. After six weeks, the patients were asked about the hand eczema, knowledge of their allergies and change in their life style to avoid the relevant allergens demonstrated on the patch test. Dermatology Life Quality Index (DLQI) was used to measure the QOL on both occasions. Results The patch test positivity was found in 68% of patients to one or more allergens. The sum score of DLQI at baseline was 12.16 ± 5.58 with median 12.0. HE had most impact on symptoms and feelings. Patients with both positive patch test (mean baseline= 11.94± 5.88; mean at six weeks=2.81± 2.01; P<0.001) and negative patch test (mean baseline=12.63± 5.03; mean at 6 weeks=5.4± 3.56; P=0.001) showed significant improvement in DLQI scores, however it was more improved in patients with positive patch test than in patients with negative patch test. Conclusions Hand eczema had an appreciable impact on the QOL. Patch testing had been beneficial to most patients in improving patient quality of life considerably. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12506 Kathmandu Univ Med J 2013; 43(3):216-220

scholarly journals Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients

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 ◽  
...  
Keyword(s):  
Contact Dermatitis ◽  
Patch Test ◽  
Clinical Features ◽  
Potassium Dichromate ◽  
Nickel Sulfate ◽  
Hand Eczema ◽  
Test Reaction ◽  
Positive Patch Test ◽  
Causative Agents ◽  
Allergic Contact

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.

scholarly journals Study of clinical profile and association of severity with contact sensitivity of hand eczema patients

2019 ◽  
Vol 5 (4) ◽  
pp. 701
Author(s):  
Shahid Hassan ◽  
Ashutosh Ranjan
Keyword(s):  
Patch Test ◽  
Potassium Dichromate ◽  
Severity Index ◽  
Hand Eczema ◽  
Clinical Profile ◽  
P Value ◽  
Contact Sensitivity ◽  
Hand Dermatitis ◽  
Positive Patch Test ◽  
Wear And Tear

<p class="abstract"><strong>Background:</strong> This present study was to evaluate the clinical profile, severity and its pattern as well as association between contact sensitivity with its severity in hand eczema patients.</p><p class="abstract"><strong>Methods:</strong> A detailed demographic profile, occupation, history regarding onset of disease, duration, progress of hand dermatitis, aggravating and relieving factors, seasonal variations, presence of atopy in self or family, day to day work, hobbies, and past and present treatment were performed to all cases of hand eczema. Severity of hand eczema was assessed by using hand eczema severity index (HECSI). Patch test was applied to all cases with standard Indian patch test battery as approved by contact dermatitis and occupational dermatoses forum of India. Data was applied by using SPSS version 26 software. P value was taken equal to or less than 0.05 for significant differences.</p><p class="abstract"><strong>Results:</strong> Hand eczema was commonly seen in male and middle age group (31-45 years) patients. Masons, house wives and farmers were mostly infected with hand eczema. Hyperkeratotic eczema and wear and tear dermatitis were the most common type of hand eczema. Potassium dichromate and nickel were the most common antigen/allergens. HECSI score 40-60 was seen in majorities of hand eczema cases. And there was no statistical significant association seen in between severity and positive patch test sensitivity in patients with hand eczema.</p><p class="abstract"><strong>Conclusions:</strong> Works associated with exposure to various chemical agents are at higher risk for developing hand eczema. Our study will of immense help to patients for identification of contact sensitizer and prevention from hand eczema.</p>

scholarly journals Relevance of patch testing in patients of chronic spontaneous urticaria and its correlation with serum IgE level

2022 ◽  
Vol 1 ◽  
pp. 17-20
Author(s):  
Trupti Desale ◽  
Abhishek De ◽  
S. K. Shahriar Ahmed ◽  
Aarti Sarda ◽  
Kiran Godse ◽  
...  
Keyword(s):  
Patch Test ◽  
Patch Testing ◽  
Potassium Dichromate ◽  
Contact Allergy ◽  
Chronic Spontaneous Urticaria ◽  
Test Reaction ◽  
Serum Ige ◽  
Positive Patch Test ◽  
Lost To Follow Up

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.

scholarly journals Common Contact Sensitizers among Patients with Hand Eczema: A Multicenter-Study in Nepal

2016 ◽  
Vol 14 (1) ◽  
pp. 14-17
Author(s):  
S. Bhattarai ◽  
A. Rijal ◽  
S. Agrawal
Keyword(s):  
Contact Dermatitis ◽  
Allergic Contact Dermatitis ◽  
Patch Test ◽  
Patch Testing ◽  
Potassium Dichromate ◽  
College Teaching ◽  
Hand Eczema ◽  
Contact Allergens ◽  
Allergic Contact

Introduction: Allergic contact dermatitis in Nepal is not an uncommon disorder. Patch testing is a well established method of diagnosing allergic contact dermatitis. Patients with contact dermatitis are well known to have impaired quality of life which often leads to frequent dermatological consultations.Objective: Lack of data from Nepal has prompted us to undertake this study with the aims to know the frequency of allergic contact dermatitis and the commonest contact allergens among the patients with Hand eczema attending the out-patient department of dermatology, B.P. Koirala Institute of Health Sciences and Kathmandu Medical College Teaching Hospital.Material and Methods: A total of 256 patients were included in the study. Out of them 195 with hand eczema agreed to participate and undergo patch testing. The antigens used included the Indian standard series of patch test allergens approved by Contact and Occupational Dermatoses Forum of India.Results: Hundred and ten cases (56.4%) were patch test positive (PTP) at 48 as well as 96 hours to at least one allergen. PTP was seen more commonly in females. The most common allergen in females was nickel sulphate followed by cobalt chloride, gentamicin and mercapto mix while males were positive to potassium dichromate, followed by epoxy resin, fragrance mix and nickel sulphate.Conclusion: Patch testing has proved a useful tool for the detection of allergic contact dermatitis and for identification of contact allergens. When positive reactions correlate with environmental exposure the test usually assists the physician in establishing the cause of dermatitis, hence treating the patients and improving their quality of life.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.14-17

scholarly journals Clinical correlation of foot eczema and patch test: a cross sectional study from South India

2021 ◽  
Vol 7 (2) ◽  
pp. 271
Author(s):  
Sharim Fathima ◽  
Kunnummal Muhammed ◽  
Gopalapillai Nandakumar
Keyword(s):  
Patch Test ◽  
South India ◽  
Potassium Dichromate ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Morphological Pattern ◽  
Cross Sectional ◽  
Endogenous Factors ◽  
Number Of Patients ◽  
Back Ground

<p class="abstract"><strong>Background:</strong> Foot eczema is caused by several exogenous or endogenous factors acting alone or in combination. Leather, rubber and adhesive components are the most common allergens. Patch test is performed to find out the allergen which helps clinician in subsequent patient management and improving the prognosis.  </p><p class="abstract"><strong>Methods:</strong> Total 50 patients with foot eczema were evaluated and patch test was performed with Indian standard series over 18 months period in a tertiary hospital in South India. <strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 50 patients 32 (64%) were females and 18 (36%) were males. Younger age group was mainly involved (second decade). An atopic back ground and seasonal exacerbation were contributory in many. Patch test was positive in 39 (78%) patients. The forefoot was predominantly involved part in 56% followed by dorsal aspect alone of the foot. Scaly plaque was the predominant morphological pattern seen in 25 (50%). Maximum number of patients (24%) showed positive reactions to potassium dichromate and the minimum (2%) to neomycin sulphate.  </p><p class="abstract"><strong>Conclusions:</strong> Though rubber and rubber chemicals were the common sensitizers causing foot eczema worldwide, our study found potassium dichromate to be the most common sensitizer which is one the components used in leather tanning and is a constituent of cement, soaps and detergents.  </p>

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

2019 ◽  
Vol 17 (1) ◽  
pp. 12-16
Author(s):  
Sushil Paudel ◽  
Guma Pun ◽  
Niraj Parajuli ◽  
Rabindra Sharma
Keyword(s):  
Patch Test ◽  
Patch Testing ◽  
Nickel Sulfate ◽  
Hand Eczema ◽  
Allergic Reactions ◽  
Positive Patch Test ◽  
Facial Eczema ◽  
Allergic Contact ◽  
Sensitization Pattern ◽  
Different Parts

Introduction: Patch testing is a diagnostic tool used in investigation to identify specific allergens in allergic contact dermatitis (ACD). It helps find the prevalence and the trends of contact sensitization in the community. Objective: To report the two year patch test results from a central hospital in Kathmandu. Materials and Methods: Consecutive consenting patients of suspected ACD were patch tested with an Indian standard Series (Systopic) from June 2014 to August 2016. Results: Out of 141 patients tested, 89 were female (63.12%) and 52 were male (36.88%). Hand eczema was the commonest pattern (53 patients) followed by persistent and recurrent eczema (44 patients) and face eczema (25 patients). Fifty- five patients (39%) had at least 1 positive allergic reaction. Among these, 16.31% were male and 22.70% were female. The most common allergen was nickel sulfate (19.9%) followed by fragrance mix (7.8%) and paraphenyldiamine (PPD) (6.4%). Out of total positive cases 27 (21 females and 6 males) had shown strong positive reactions (++). The Nickel Sulfate was responsible in majority of cases (18/27 cases). Farmers had the highest (57.14%) rate of positive allergic reactions followed by housewives (39.62%). According to the regional eczema, patients with persistent and recurrent eczema of different parts of body had the highest rate of positive allergic reactions (47.72%). Almost half of patient with facial eczema (40%) had positive patch test. Conclusion: Larger studies are required in the different parts of the country to find a more accurate data regarding the sensitization pattern in Nepalese population.

scholarly journals EVALUATION OF PATCH TESTING IN CONTACT DERMATITIS PATIENTS ATTENDING TERTIARY CARE CENTRE IN KARAIKAL

2021 ◽  
pp. 20-22
Author(s):  
SivaKumar Sivasubramaniam ◽  
Ambujam Govindasamy ◽  
Kode Leela Sravanthi ◽  
Brindha Pandiyan
Keyword(s):  
Contact Dermatitis ◽  
Patch Test ◽  
Patch Testing ◽  
Potassium Dichromate ◽  
Tertiary Care ◽  
Nickel Sulfate ◽  
Cobalt Sulfate ◽  
Tertiary Care Centre ◽  
Positive Patch Test ◽  
Contact Eczema

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

Sign in / Sign up

Export Citation Format

Share Document