Contact sensitizers in dyshidrotic eczema
Keywords:
Dyshidrotic eczema, Pompholyx, Patch test, Contact dermatitis.Abstract
Objective To study the etiological pattern of contact sensitizers in patients of dyshidrotic eczema. Methods 50 patients of suspected and provisionally diagnosed as having dyshidrotic eczema were subjected to patch test with Indian Standard Battery developed by Contact and Occupational Dermatoses Forum of India (CODFI). Results were read after 48 hours of application and second reading, if required, was taken after 72-96 hours. Results Patch test analysis of these patients revealed that out of 50 patients 26 (52%) showed positive result with patch test. Paraphenylenediamine (20%) and nickel sulphate (10%) were the commonest allergens, followed by parthenium (8%), fragrance mix (8%) and potassium dichromate (8%). Conclusion Careful history and examination of the patients helps to ascertain the probable relevant allergen responsible for the disease flare up. The patients of pompholyx with positive patch test results can be advised to avoid these allergens.References
Smith HR, White IR, Rycroft RJ, McFadden JP. Descriptive comparison of isolated hand dermatitis and other populations at St. John's Contact Dermatitis Clinic. Contact Dermatitis. 2000;43:51-2.
Veien NK. Acute and recurrent vesicular hand dermatitis. DermatolClin. 2009;27:337–53.
Fox T. Clinical lecture on dyshidrosis: an undescribed eruption. Br Med J. 1873;365-6.
Ackerman AB, Ragaz A. A plea to expunge the word “eczema” from the lexicon of dermatology and dermatopathology. Arch Dermatol Res. 1982; 272:407-20.
Berth JJ. Eczema, Lichenification, Prurigo and Erythroderma. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s Textbook Of Dermatology. 8th ed. Chichester, West Sussex: Wiley:Blackwell Publication; 2010.p. 23.1-51.
Altekrueger I, Ackerman AB. "Eczema" revisited. A status report based upon current textbooks of dermatology. Am J Dermatopathol. 1994;16:517-22.
Meding B, Swanbeck G. Epidemiology of different types of hand eczema in an industrial city. ActaDermVenereol. 1989;69:227-33.
Guillet MH, Wierzbicka E, Guillet S, Dagregorio G,et al. A 3-year causative study of pompholyx in 120 patients. Arch Dermatol. 2007;143:1504-8.
Jain VK, Aggarwal K, Passi S, Gupta S. Role of contact allergens in pompholyx. J Dermatol. 2004;31:188-93.
Lodi A, Betti R, Chiarelli G, Urbani CE, et al. Epidemiological, clinical and allergological observations on pompholyx. Contact Dermatitis. 1992;26:17-21.
Bryld LE, Agner T, Menné T. Relation between vesicular eruptions on the hands and tinea pedis, atopic dermatitis and nickel allergy. ActaDermVenereol. 2003;83:186-8.
Fredricks MG, Becker FT. Vesicular eruptions of the hands and feet of dyshidrotic type: clinical and therapeutical analysis. AMA Arch DermSyphilol. 1954;70:107-14.
Meding B. Epidemiology of hand eczema in an industrial city. ActaDermVenereolSuppl (Stockh). 1990;153:1-43.
DeLeo VA, Suarez SM, Maso MJ. Photoallergiccontatct dermatitis. Results of photopatch testing in New York, 1985-1990. Arch dermatol. 1992;128:1513-8.
Grauer FH, Lorincz AL. Simultaneous dyshidrosis in monozygotic twins during their separation. AMA Arch Derm. 1956;74:250-2.
Christensen OB, Möller H. Nickel allergy and hand eczema. Contact Dermatitis. 1975; 1:129–35.
Lehucher-Michel MP, Koeppel MC, Lanteaume A, Sayag J. Dyshidrotic eczema and occupation: a descriptive study. Contact Dermatitis. 2000;43:200-5.
Veien NK, Hattel T, Laurberg G. Plantar Trichophytonrubrum infections may causedermatophytids on the hands. ActaDermVenereol. 1994;74:403-4.
Katz SA, Samitz HH. Leaching of nickel from satinless steel consumer commodities. ActaDermvenereol. 1975;55:113-5.