Related Experiment Video
Updated: May 13, 2026
A Mouse Ear Model for Allergic Contact Dermatitis Evaluation
Published on: March 24, 2023
Footwear contact dermatitis from dimethyl fumarate
Danka Švecová1, Maria Šimaljakova, Anna Doležalová
1Department of Dermatoneverology, Faculty of Medicine, Comenius University, Bratislava, Slovakia. danka.svecova@fmed.uniba.sk
Background:
Dimethyl fumarate (DMF) is an effective inhibitor of mold growth. In very low concentrations, DMF is a potent sensitizer that can cause severe allergic contact dermatitis (ACD). It has been identified as the agent responsible for furniture contact dermatitis in Europe. The aim of this study was to evaluate patients in Slovakia with footwear ACD associated with DMF, with regard to clinical manifestations, patch test results, and results of chemical analysis of their footwear.
Methods:
Nine patients with suspected footwear contact dermatitis underwent patch testing with the following allergens: samples of their own footwear, commercial DMF, the European baseline, shoe screening, textile and leather dye screening, and industrial biocides series. The results were recorded according to international guidelines. The content of DMF in footwear and anti-mold sachets was analyzed using gas chromatography and mass spectrometry.
Results:
Acute ACD was observed in nine Caucasian female patients. All patients developed delayed sensitization, as demonstrated by positive patch testing using textile footwear lining. Seven patients were patch tested with 0.1% DMF, and all seven were positive. Chemical analysis of available footwear showed that DMF was present in very high concentrations (25-80 mg/Kg).
Conclusions:
Dimethyl fumarate is a new footwear allergen and was responsible for severe ACD in our patients. To avoid an increase in the number of cases, the already approved European preventive measures should be accepted and commonly employed.
Insights
Dimethyl fumarate (DMF) is a new allergen causing severe allergic contact dermatitis (ACD) from footwear. This study identified DMF in footwear, confirming its role in ACD cases and recommending preventive measures.
Area of Science:
- Dermatology
- Toxicology
- Analytical Chemistry
Background:
- Dimethyl fumarate (DMF) is an effective mold inhibitor but a potent sensitizer causing allergic contact dermatitis (ACD).
- DMF has been identified as the cause of furniture contact dermatitis in Europe.
- Footwear is a potential source of exposure to DMF, leading to ACD.
Purpose of the Study:
- To evaluate clinical manifestations and patch test results in Slovak patients with footwear-associated ACD.
- To determine the presence and concentration of DMF in footwear using chemical analysis.
Main Methods:
- Nine patients with suspected footwear ACD underwent patch testing with footwear samples and various allergens.
- Gas chromatography and mass spectrometry were used to analyze DMF content in footwear and anti-mold sachets.
Main Results:
- All nine patients presented with acute ACD and demonstrated delayed sensitization to textile footwear lining.
- Patch testing with 0.1% DMF was positive in all seven tested patients.
- Chemical analysis revealed high concentrations of DMF (25-80 mg/Kg) in the analyzed footwear.
Conclusions:
- Dimethyl fumarate is identified as a novel footwear allergen responsible for severe ACD.
- Implementing approved European preventive measures is crucial to reduce the incidence of DMF-induced ACD.
Related Concept Videos
01:31Diabetic Foot Ulcer
01:23Skin Diseases and Disorders
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
01:30Drug Toxicity: Allergic Reactions
01:27The Skin Microbiota
01:23Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin D3(cholecalciferol).
01:28Fungal Phylum Microsporidia