Contact allergens in shoe leather among patients with foot eczema

Abstract

Some patients with relapsing foot eczema and a shoe leather allergy, who fail to show positive results with standard series and shoe wear screening tray patch testing, do not respond to the use of hypoallergenic shoe leather. We assume that relevant allergens are present in hypoallergenic shoe leather. We described an experiment to demonstrate the presence of these allergens. Alcoholic extracts were made of green, black and undyed hypoallergenic shoe leather, and the extracts were fractioned by paper chromatography. The resulting chromatograms were cut into 16 equal paper disks and patch tests were performed with extracts and the paper chromatography fractions. Positive reactions were seen to all extracts and to fractions of all types of leather. From analysis of the pattern of positive patch tests we concluded that leather-related allergens (e.g. tanning agent) and dyes were present in hypoallergenic shoe leather. In these cases, alternatives to shoe leather should be sought, for instance wooden or plastic shoes.

Consumer leather exposure: an unrecognized cause of cobalt sensitization

“…This typically involves fixing a variety of compounds onto the very reactive chromium (http://nzic.org.nz/ChemProcesses/animal/5C.pdf). As previously stated, little is known about the tanning agents and dyes used, and much information is unknown or kept secret by manufacturers (14). However, a recent article listed potential contact sensitizers in Indonesian leather workers (15); the dyeing agents included Disperse Orange 3, Acid Yellow, N-isopropyl-N-phenyl-4-phenylenediamine, hydrogen peroxide, and benzidine, but not cobalt.…”

The relation between the localization of foot dermatitis and the causative allergens in shoes: a 13‐year retrospective study

“…Patients with ACD to shoe components are usually advised to wear shoes made of ‘hypoallergenic’ material, which has proven to be effective in some cases (7). Indeed, in our experience, the results obtained with extracts from ‘hypoallergenic’ leather vary greatly between the subjects tested.…”

“…In these cases, the following recommendations can be made: wearing wooden or plastics shoes, wearing good‐quality new leather shoes and discarding them after a few months (thus preventing the allergens from leaching out) and wearing extra pairs of socks in shoes that are too large (thus preventing contact with the allergens). These simple measures can, according to certain authors (7, 12), result in clearance of half the cases of allergic shoe eczema due to an unknown allergen.…”

Allergic contact dermatitis due to orthopedic shoes and a prosthesis for an amputated foot

“…Potassium dichromate, found in construction materials (primary sensitizers in our patient), is also a tanning agent for leather products (2–5).…”

“…Shoe allergens can be leached out by profuse sweating associated with a hot climate, friction and occlusion, particurarly in old shoes (3, 4, 6).…”