Common allergens in shoe dermatitis: our experience in Lahore, Pakistan.
BACKGROUND
Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes. Different chemicals, in conjunction with a hot and humid environment within the shoe, give rise to allergic or irritant dermatitis. Allergic shoe dermatitis is commonly caused by constituents of rubber, leather, adhesives, and rarely by linings and dyes.


OBJECTIVE
To determine the frequency of various allergens in shoe dermatitis in our patients.


METHODS
One hundred and nine patients suspected of having contact dermatitis due to shoe allergens were included. All patients were patch tested with the Shoe series and European Standard series. Patches were applied on the upper back and removed after 48 h. Results were read at 48, 72, and 120 h and interpreted according to International Contact Dermatitis Research Group (ICDRG) criteria.


RESULTS
Of the 119 patients, 87 (73%) reacted positively to various allergens, 48% of whom showed polysensitivity. Glues (33.6%), particularly para-tert-butylphenol formaldehyde resin (PTBP-FR) (26.9%), were the leading cause of shoe dermatitis. Other allergens were leather chemicals (26.4%), potassium dichromate (16.18%), rubber allergens (7.6%), and dyes (7.6%). Shoe scrapings tested positive in 26.3% of patients. Other common allergens were nickel sulfate (22.7%), neomycin sulfate (10.1%), and cobalt chloride (8.4%).


CONCLUSIONS
Considering the diversity of allergens, all patients presenting with shoe dermatitis should be patch tested with the Shoe series and a standard series to determine the etiologic allergens.
Rani
Zahida
Z
Department of Dermatology, King Edward Medical College/Mayo Hospital, Lahore, Pakistan. dderma@paknet4.ptc.pk
Hussain
Ijaz
I
Haroon
Tahir Saeed
TS
D000269:Adhesives / Q000009:adverse effects; D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D004396:Coloring Agents / Q000009:adverse effects; D003877:Dermatitis, Contact / Q000209:etiology*; D005260:Female; D005533:Foot Dermatoses / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010328:Patch Tests; D012408:Rubber / Q000009:adverse effects; D012775:Shoes / Q000009:adverse effects*
D000269:Adhesives; D000485:Allergens; D004396:Coloring Agents; D012408:Rubber