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Patch Testing in Allergic Contact Dermatitis over the Lower Extremities.
Bommireddy Vinay Kumar1, P Kombettu Ashwini1, Garehatty Rudrappa Kanthraj1
1Department of Dermatology, Venereology and Leprology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Indian Journal of Dermatology
|April 16, 2019
Summary
Allergic contact dermatitis (ACD) of the lower extremities is often caused by common allergens like potassium dichromate and nickel. Polysensitization to chemicals in footwear and topical products is frequent.
Area of Science:
- Dermatology
- Allergology
- Contact Dermatitis
Background:
- Allergic contact dermatitis (ACD) incidence is rising on lower extremities.
- Contributing factors include topical preparations, occupational exposures, and chemicals in footwear manufacturing.
Purpose of the Study:
- To identify common allergens causing ACD on lower extremities.
- To investigate patterns of polysensitization in these patients.
Main Methods:
- A cross-sectional study involving 80 patients over 18 months.
- Demographic and clinical data collection.
- Patch testing using the Indian standard series with readings at 48 and 96 hours.
Main Results:
- Potassium dichromate (35%) and nickel sulfate (23.5%) were the most frequent allergens.
- Neomycin was a common cause of dermatitis medicamentosa.
- Polysensitization was observed with mercapto mix, mercaptobenzothiazole, and fragrance mix.
Conclusions:
- Potassium dichromate and nickel are primary allergens for lower extremity ACD.
- Mercapto mix, mercaptobenzothiazole, and fragrance mix are implicated in polysensitization.
- Late patch test readings (≥96h) and screening topical product use are recommended.
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