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A Study Assessing Patch Test Results in Hand and Foot Eczema Patients at a Tertiary Care Hospital
C Balakumaran1, G Sukanya, N Ashok Kumar
1Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
Background:
Eczema of hand and foot is one of the most common dermatological conditions encountered in the outpatient clinic. Both endogenous and exogenous factors can cause eczema identification and elimination of the triggering factor becomes essential.
Aims And Objectives:
The primary objective of the study was to assess the diagnostic outcomes of patch testing in hand and foot eczema and to study the distribution of clinical patterns and aetiologies causing hand and foot eczema.
Materials And Methods:
Thirty patients diagnosed with hand and foot eczema had a patch test using Indian standard battery series. This prospective observational study was carried out over 18 months at a tertiary care hospital in Chromepet, Chennai, Tamil Nadu, India. Data entry was done on Microsoft Excel and data analysis was done using SPSS 22 version. P < 0.005 was considered to be significant throughout the study. Patients diagnosed with hand and foot eczema had patch test done using indian standard battery series. The patients were followed up at 48 and 72 h, respectively, and the results were interpreted using international contact dermatitis research group (ICDRG) grading.
Results:
The study population comprised predominantly of 18 (60%) males and 12 (40%) females with 16 (53.3%) of the entire study population being 41-60 years. Hand eczema was the most common presentation: 19 (63.3%) patients, with itching reported in 29 (96.75%) patients and dryness in 24 (80%) patients, bilateral involvement was observed in 25 (83.3%) cases. The most common exposure was to gloves in 15 (50%) patients followed by detergents in 9 (30%) patients. Hyperkeratotic hand and foot eczema was the most frequent morphological finding documented in 6 patients (20%). Of the 30 patients who had patch testing done, 9 patients (30%) had one positive antigen, 3 had (10%) had three positive antigens, 1 patient (3.3%) had two positive antigens and 17 (56.7%) patients had no positive antigens. The most common antigen was potassium dichromate (25%).
Conclusion:
Hand and foot eczema remains a challenging dermatological condition due to its chronicity and multifactorial aetiology. Hand eczema is more prevalent than foot eczema and comprises a major part of occupational dermatoses. Patch test being a non-invasive tool helps in ascertaining the causative allergen and plays a significant role in the management of eczema, as avoidance of the allergen forms the cornerstone in the treatment of eczema.
