Common allergens in patients with contact dermatitis identified using patch test in a tertiary care centre in North Kerala

Authors

  • V. P. K. Gopinath Department of Dermatology, MES Medical College, Kerala, India
  • V. M. Simi Department of Dermatology, MES Medical College, Kerala, India
  • K. Basheer Ahammed Department of Dermatology, MES Medical College, Kerala, India
  • C. M. Ali Rishad Department of Dermatology, MES Medical College, Kerala, India
  • P. M. Farisa Department of Dermatology, MES Medical College, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20185054

Keywords:

Allergic contact dermatitis, Patch test, ISS, Black rubber, Nickel

Abstract

Background: Allergic contact dermatitis (ACD) is a disease characterised by an immune mediated response to a substance. The primary prevention remains avoidance of the implicated allergen. This is done with the help of patch test using the Indian Standard series (ISS).

Methods: Out of the 246 cases of ACD that came to our Dermatology department, 92 patients were selected and subjected to patch testing using the ISS. Results were read after 48 and 96 hours, interpreted as per ICDRG criteria and were analysed.

Results: From 92 patients 59.8% were males and 40.2% were females. Majority of the individuals with ACD who were patch tested belonged to the age range of 21-60 years accounting to 72.8%. The most affected site was the foot. 26.7% showed positivity to Black rubber mix, followed by potassium dichromate 20% and nickel 14.4%. 7.8% produced delayed reactions with positivity revealed at the final reading. One patient gave multiple positive reactions to paraben, PPD and chlorocresol.

Conclusions: In the study middle aged males were mostly affected which may be influenced by the sample selected. Black rubber mix was identified as the most frequent sensitizer followed by potassium dichromate which was also implicated as the sensitizer most seen in the unskilled generally. Fragrance mix was responsible for all delayed responses yielding positivity in the second reading. When not considering the negligible left, patch tests’ results could be correlated with the clinical presentations. Patients were treated, educated on ACD and advised to refrain from exposure with suggestions of possible alternatives.

Author Biographies

V. P. K. Gopinath, Department of Dermatology, MES Medical College, Kerala, India

PROFESSOR AND HEAD OF DEPARTMENT

Dept Of Dermatology

V. M. Simi, Department of Dermatology, MES Medical College, Kerala, India

ASSOCIATE PROFESSOR

DEPT OF DERMATOLOGY

K. Basheer Ahammed, Department of Dermatology, MES Medical College, Kerala, India

ASSISTANT PROFESSOR

DEPT OF DERMATOLOGY

C. M. Ali Rishad, Department of Dermatology, MES Medical College, Kerala, India

JUNIOR RESIDENT

DEPT OF DERMATOLOGY

P. M. Farisa, Department of Dermatology, MES Medical College, Kerala, India

JUNIOR RESIDENT

DEPT OF DERMATOLOGY

References

Sarma N, Ghosh S. Clinico-allergological pattern of allergic contact dermatitis among 70 Indian children. Indian J Dermatol Venereol Leprol. 2010;76:38-44.

Nagure AKB, Kalyanrao YG. A study on correlation between allergen and allergic contact dermatitis. Int J Res Dermatol. 2017;3:459-64.

Jones R, Horn HM. Identifying the causes of contact dermatitis. Practitioner. 2014;258:27-31.

Kwangsukstith C, Maibach HI. Effect of age and sex on the induction and elicitation of allergic contact dermatitis. Contact dermatitis. 1995;33:289-98.

Cohen DE, Heidary N. Treatment of irritant and allergic contact dermatitis. Dermatol Ther. 2004;17:334-40.

Robert L. Fisher’s Contact Dermatitis. In: Robert L, editor. Fisher’s Contact Dermatitis. 6th ed. Hamilton; 2008: 11.

Freireich-Astman M, David M, Trattner A. Standard patch test results in patients with contact dermatitis in Israel: age and sex differences. Contact Dermatitis. 2007;56:103-7.

Rajagopalan R, Anderson RT, Sarma S, Kallal J, Retchin C, Jones J, et al. An economic evaluation of patch testing in the diagnosis and management of allergic contact dermatitis. Am J Contact Dermat. 1998;9:149-54.

Frosch PJ. Irritant Contact Dermatitis. In: Frosch PJ, Dooms-Goossens A, Lachapelle JM, Rycroft RJG, Scheper RJ. (eds) Current Topics in Contact Dermatitis. Berlin, Heidelberg: Springer; 1998.

Pigatto PD. Contact dermatitis: some important topics. Eur Ann Allergy Clin Immunol. 2015;47:188-91.

Wolf R, Orion E, Ruocco V, Baroni A, Ruocco E. Patch testing: facts and controversies. Clin Dermatol. 2013;31:479-86.

Rajagopalan R, Anderson RT, Sarma S, Kallal J, Retchin C, Jones J, et al. An economic evaluation of patch testing in the diagnosis and management of allergic contact dermatitis. Am J Contact Dermat. 1998;9:149-54.

Bordel-Gómez MT, Miranda-Romero A, Castrodeza-Sanz J. Epidemiology of contact dermatitis: prevalence of sensitization to different allergens and associated factors. Actas Dermosifiliogr. 2010;101:59-75.

Walton S, Nayagam AT, Keczkes K. Age and sex incidence of allergic contact dermatitis. Contact Dermatitis. 1986;15:136-9.

Mortz CG, Andersen KE. Allergic contact dermatitis in children and adolescents. Contact Dermatitis. 1999;41:121-30.

Militello, Giuseppea, Jacob, Sharon E, Crawford, Glen H. Allergic contact dermatitis in children. Current Opinion in Pediatrics. 2006;18:385–90.

Sarma N. Occupational Allergic Contact Dermatitis Among Construction Workers In India. Indian J Dermatol. 2009;54:137–41.

Madhavi LM, Gonapati P, Masthan Saheb D. Evaluation of Patch Test in 100 Cases of Allergic Contact Dermatitis. Indian J Mednodent Allied Sci. 2016;4:118-25.

Wildemore JK, Hopkins JM, DJames W. Evaluation of the histologic characteristics of patch test confirmed allergic contact dermatitis. J Am Acad Dermatol. 2003;49:243-8.

Hausen BM, Krueger A, Mohnert J, Hahn H, König WA. Contact allergy due to colophony (III). Sensitizing potency of resin acids and some related products. Contact Dermatitis. 1989;20:41-50.

Vigneshkarthik N, Ganguly S, Kuruvila S. Patch Test as a Diagnostic Tool in Hand Eczema.J Clin Diagn Res. 2016;10:4-7.

Narendra G, Srinivas CR. Patch testing with Indian standard series. Indian J Dermatol Venereol Leprol. 2002;68:281-2.

Dickel H, Taylor JS, Bickers DR, Merk HF, Bruckner TM. Multiple patch-test reactions: a pilot evaluation of a combination approach to visualize patterns of multiple sensitivity in patch-test data bases and a proposal for a multiple sensitivity index. Am J Contact Dermat. 2003;14:148-53.

Degreef H, Goossens D, Coopman S. Identification Of Cross Reaction Patterns in Allergic Contact Dermatitis From Topical Corticosteroids. Br J Dermatol. 1989;121:27-34.

Lewis PG, Emmett EA. Irritant dermatitis from tri-butyl tin oxide and contact allergy from chlorocresol. Contact Dermatitis. 1987;17:129-32.

Nanda A, Wasan A. Allergic contact dermatitis to balsam of Peru. Ann Allergy Asthma Immunol. 2016;117:208-9.

Thyssen JP, Linneberg A, Menné T, Johansen JD. The epidemiology of contact allergy in the general population--prevalence and main findings. Contact Dermatitis. 2007;57:281-99.

Thyssen JP, Jensen P, Carlsen BC, Engkilde K, Menné T, Johansen JD. The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure. Br J Dermatol. 2009;161:1288-93.

Sharma VK, Verma P. Parthenium dermatitis in India: Past, present and future. Indian J Dermatol Venereol Leprol. 2012;78:560-8.

Yoganand J, Phulari. Clinical correlation of patch testing in suspected Allergic Contact Dermatitis. Int J Biomed Res. 2017;8:547-50.

Babu A, Venna, Kothandapany, Srivenkateswaran. A Clinical Study on Kumkum and Bindi Dermatitis And Their Relevance To Patch Testing. J Evol Med Dental Sci. 2016;5:14-25.

Davis MD, Bhate K, Rohlinger AL, Farmer SA, Richardson DM, Weaver AL. Delayed patch test reading after 5 days: the Mayo Clinic experience. J Am Acad Dermatol. 2008;59:225-33.

Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis. 2015;73:195-221.

Lazzarini R, Duarte I, Ferreira AL. Patch tests. Anais Brasileiros de Dermatologia. 2013;88(6):879-88.

Downloads

Published

2019-01-25

Issue

Section

Original Research Articles