Patch testing is the standard diagnostic tool for shoe allergic contact dermatitis (ACD). As shoe materials change over time, utilizing commercial allergen series might be ineffective. However, because testing with patients' shoe samples is laborious, its value is questioned.
Objective
The aim of this study was to ascertain the benefits of patch testing with patients' shoes by comparing the frequencies of patch-test positivity of shoes and shoe-related allergens in baseline series for suspected shoe ACD patients.
Methods
A retrospective study was conducted of patients with clinically suspected shoe ACD who underwent patch testing with baseline series and shoe samples 2000 to 2019.
Results
Almost half of the cohort (77 of 178; 43.3%) was diagnosed with shoe ACD. Of those 77, 48 (62.3%) were positive to shoe-related allergens from the baseline series, whereas 53 (68.8%) were positive to their shoe materials. The prevalence of tests positive to shoe material but negative to shoe-related allergens was 29 of 77 (37.7%). The most common shoe-related allergens were potassium dichromate (7.9%), carba mix (6.8%), and mercapto mix (6.7%).
Conclusions
Patch testing with shoe materials increased the diagnostic yield by 37.7 percent. To diagnose shoe ACD, testing of shoe materials may compensate for unknown, scarce, or novel allergens not in the baseline series.
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References
1.
LandeckL, UterW, JohnSM. Patch test characteristics of patients referred for suspected contact allergy of the feet—retrospective 10-year cross-sectional study of the IVDK data. Contact Dermatitis, 2012; 66(5):271–278.
RaniZ, HussainI, HaroonTS. Common allergens in shoe dermatitis: our experience in Lahore, Pakistan. Int J Dermatol, 2003; 42(8):605–607.
4.
HoldenCR, GawkrodgerDJ. 10 years' Experience of patch testing with a shoe series in 230 patients: which allergens are important?. Contact Dermatitis, 2005; 53(1):37–39.
5.
TraidlS, WerfelT, RuëffF, et al.Patch-test results in patients with suspected contact allergy to shoes: retrospective IVDK data analysis 2009–2018. Contact Dermatitis 2021.
6.
BoonchaiW, KasemsarnP. Suitability of patch test allergens for standard series in Thai patients: ten-year retrospective review of patch test results. J Dermatol, 2013; 40(1):65–67.
7.
RietschelRL, FowlerJF. Textiles and shoes. In: Fisher's Contact Dermatitis. 6th ed. Hamilton, Ontario, Canada: BC Decker; 2008:339–369.
8.
PongpairojK, AleI, AndersenKE, et al.Proposed ICDRG classification of the clinical presentation of contact allergy. Dermatitis, 2016; 27(5):248–258.
9.
ChowdhuriS, GhoshS. Epidemio-allergological study in 155 cases of footwear dermatitis. Indian J Dermatol Venereol Leprol, 2007; 73(5):319–322.
10.
RasoolF, SehgalVN, SrivastavaG, et al.Footwear contact dermatitis: a prospective cross-sectional study of 108 outpatients from Delhi, India. Skinmed, 2018; 16(2):90–97.
11.
PriyaKS, KamathG, MartisJ, et al.Foot eczema: the role of patch test in determining the causative agent using standard series. Indian J Dermatol, 2008; 53(2):68–69.
12.
SahaM, SrinivasCR, ShenoySD, et al.Footwear dermatitis. Contact Dermatitis, 1993; 28(5):260–264.
13.
KhanMS, ShaukatS, AhmadTJ. Frequency of nickel sensitivity in patients with shoe dermatitis. J Pakistan Assoc Dermatologists, 2017; 27(1):15–18.
14.
GargT, AgarwalS, RanaS, et al.Patch testing in patients with suspected footwear dermatitis: a retrospective study. Indian Dermatol Online J, 2017; 8(5):323–327.
15.
MohantyS, PodderI, GhoshA, et al.Clinico-demographic profile of patients with foot dermatitis: a cross-sectional study with special reference to patch test results. Indian J Dermatol, 2020; 65(5):377–380.
16.
WarshawEM, SchramSE, BelsitoDV, et al.Shoe allergens: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001–2004. Dermatitis, 2007; 18(4):191–202.
17.
MorettoA.Hexavalent and trivalent chromium in leather: what should be done?. Regul Toxicol Pharmacol, 2015; 73(2):681–686.
18.
HansenMB, JohansenJD, MennéT. Chromium allergy: significance of both Cr(III) and Cr(VI). Contact Dermatitis, 2003; 49(4):206–212.
19.
AithalV, JacobM. Foot eczema and footwear dermatitis: role of patch test using Indian standard series and footwear series. Clinical Dermatology Review, 2019; 3(1):62–67.
20.
FebrianaSA, SoebonoH, CoenraadsPJ, et al.Contact allergy in Indonesian patients with foot eczema attributed to shoes. J Eur Acad Dermatol Venereol, 2015; 29(8):1582–1589.
21.
Encabo DuránB, Romero-PérezD, Silvestre SalvadorJF. Allergic contact dermatitis due to paraphenylenediamine: an update. Actas Dermosifiliogr (Engl Ed), 2018; 109(7):602–609.
22.
UterW, LessmannH, GeierJ, et alIVDK Study Group; German Contact Dermatitis Research Group (DKG). The spectrum of allergic (cross-)sensitivity in clinical patch testing with ‘para amino’ compounds. Allergy, 2002; 57(4):319–322.
23.
NardelliA, TaveirneM, DriegheJ, et al.The relation between the localization of foot dermatitis and the causative allergens in shoes: a 13-year retrospective study. Contact Dermatitis, 2005; 53(4):201–206.
24.
ThomasBR, WhiteIR, McFaddenJP, et al.Positive relationship-intensity of response to p-phenylenediamine on patch testing and cross-reactions with related allergens. Contact Dermatitis, 2014; 71(2):98–101.
25.
AertsO, GoossensA, LambertJ, et al.Contact allergy caused by isothiazolinone derivatives: an overview of non-cosmetic and unusual cosmetic sources. Eur J Dermatol, 2017; 27(2):115–122.
26.
SilvaCA, El-HouriRB, ChristensenLP, et al.Contact allergy caused by methylisothiazolinone in shoe glue. Contact Dermatitis, 2017; 77(3):175–176.
27.
SukakulT, ChaweekulratP, LimphokaP, et al.Changing trends of contact allergens in Thailand: a 12-year retrospective study. Contact Dermatitis, 2019; 81(2):124–129.
ÖzkayaE, Polat EkinciA. Foot contact dermatitis: nitrofurazone as the main cause in a retrospective, cross-sectional study over a 16-year period from Turkey. Int J Dermatol, 2016; 55(12):1345–1350.
30.
HedbergYS, ErfaniB, MaturaM, et al.Chromium(III) release from chromium-tanned leather elicits allergic contact dermatitis: a use test study. Contact Dermatitis, 2018; 78(5):307–314.
31.
HulstaertE, BergendorffO, PerssonC, et al.Contact dermatitis caused by a new rubber compound detected in canvas shoes. Contact Dermatitis, 2018; 78(1):12–17.
LazzariniR, MendonçaRF, HafnerMFS. Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis. An Bras Dermatol, 2018; 93(5):696–700.
35.
AertsO, HermanA, MowitzM, et al.Isobornyl acrylate. Dermatitis, 2020; 31(1):4–12.
36.
Raison-PeyronN, BergendorffO, BourrainJL, et al.Acetophenone azine: a new allergen responsible for severe contact dermatitis from shin pads. Contact Dermatitis, 2016; 75(2):106–110.
