Patch testing in hand eczema: a cross-sectional study from a teaching hospital of North India

Abstract

Background: Hand eczema is a common dermatological disorder in different occupational groups with multifactorial etiology. Patch Testing serves as an important tool for identifying responsible allergens.Methods: The study was conducted in the Department of Dermatology, SKIMS-MCH, Srinagar for duration of one year from June 2016 to June 2017. Patients of either gender with hand eczema, aged 18 years and above, presenting to outpatient department were enrolled in the study. After taking informed written consent from patients, a detailed history was taken, and clinical examination was performed on first visit. Patch testing with Indian Standard Series was performed a fortnight after complete resolution of signs and symptoms of eczema and after complete withdrawal of the drugs.Results: Out of 116 patients 60 (51.7%) were males and 56 (48.3%) were females. Male to female ratio was 1.07:1. Mean age of presentation of females was 35.42±12.52years and of males was 49.2±10.01years. The commonest allergen was Nickel sulphate (23.2%) followed by Potassium dichromate (15.1%). Nickel sulphate was most common allergen in females while Cobalt sulphate and Paraphenylene diamine were most common allergens in males. House wives (36.2%) and farmers (11.2%) were occupations with high frequency of hand eczema.Conclusions: Patch testing in clinically diagnosed cases of hand eczema can play a vital role in not just the confirmation of the label but can also reduce the socio-economic burden on such patients.

Patch testing in hand and foot eczema: A prospective study at a tertiary care hospital

“…A significantly higher patch test positivity (48%-82%) has been reported by most Indian studies [6,7,9,10,15] . Nickel, followed by potassium bichromate was the most frequently encountered allergen, exclusively in hand eczema similar to Suman et al [6] , Majid et al [7] and Qayoom et al [12] studies. None of our patients tested positive to fragrance mix.…”

“…Aithal V et al (2019) [4] Foot eczema 60% Parthenium, Mercaptobenzothiazole, Potassium Dichromate Suman M et al (2003) [6] Hand eczema 67% Nickel Sulphate, Potassium Dichromate Majid I (2016) [7] Hand eczema 48.5% Nickel Sulphate, Potassium Dichromate Vigneshkarthik N et al (2016) [8] Hand eczema 37% Nickel Sulphate, Para-Phenylenediamine, Potassium Dichromate Laxmisha C et al (2008) [9] Hand eczema 52.78% Potassium Dichromate Kishore NB et al (2005) [10] Hand eczema 82% Potassium Dichromate. Nickel Sulphate, Qayoom S et al (2018) [12] Hand eczema 72.41% Nickel Sulphate, Potassium Dichromate, Balsam of Peeru, Cobalt Sulphate, Paraphylene Diamine Mehta MJ et al (2015) [13] Hand, head-neck and feet eczema 51.33% Parthenium, Fragrance Mix Priya KS et al (2008) [14] Foot eczema 88% Mercaptobenzothiazole, Colophony, 4-Phenylenediamine Base, Potassium Dichromate, Formaldehyde, Nickel Sulfate Handa S et al (2012) [15] Hand eczema 65% Potassium Dichromate, Fragrance Mix, Nickel Sulphate Kumar BV et al (2019) [18] Lower extremity eczema 75% Potassium Dichromate, Nickel Sulfate, Mercapto Mix, Mercaptobenzothiazole John V et al (2014) [19] Lower leg and foot eczema 46% Potassium Dichromate, Paraben Mix Nickel Sulfate…”

“…Hence, patch testing is an important tool to confirm the presence of allergy and to identify the actual allergen. Majority studies in literature have focused on hand eczema [6][7][8][9][10][11][12][13] and few on foot eczema [4,5] . They have documented varying clinical pattern and different types of allergens as causative cause [4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

“…Majority studies in literature have focused on hand eczema [6][7][8][9][10][11][12][13] and few on foot eczema [4,5] . They have documented varying clinical pattern and different types of allergens as causative cause [4][5][6][7][8][9][10][11][12][13][14][15][16] . Depending on geographical, occupational, economic and social factors, allergen exposures may vary [8] .…”