Contact sensitization in venous eczema: preliminary results of patch testing with Indian standard series and topical medicaments.
OBJECTIVE
Elimination of allergens/topical medications causing contact dermatitis in venous eczema, which poses a significant problem in its chronicity and treatment, provides the basis for better therapeutic outcome. Our objective was to determine the pattern of contact sensitization in venous eczema patients in Himachal Pradesh (India).


METHODS
Thirty-four patients (M:F, 31:3) and 10 controls (M:F, 6:4) were patch tested with Indian standard series and 10 commonly used topical medicaments.


RESULTS
Positive patch test results were seen in 50% (M:F, 16:1) of the patients. Common allergens were Fragrance mix (15%), p-phenylendiamine (15%), nickel (9%), wool alcohol (9%), chinoform (9%), balsum of Peru (5%), cobalt chloride (5%), potassium dichromate (3%), epoxy resin (3%), thiuram mix (3%) and formaldehyde (3%). Only sisomycin and miconazole among the topical medications elicited a positive patch test reaction in 3 and 5% patients, respectively. Neomycin contact sensitivity was not seen in any of the patients. One patient who had exacerbation of venous eczema following accidental application of topical diclofenac showed a positive patch test reaction to it.


CONCLUSIONS
Patch test should be used to identify the topical agents that may be responsible for perpetuation or aggravation of eczema, especially in patients who do not improve despite adequate treatment of other underlying cause(s).
Jindal
Rashmi
R
Department of Dermatology, Venereology and Leprosy, Indira Gandhi Medical College, Shimla, India.
Sharma
Nand Lal
NL
Mahajan
Vikram K
VK
Tegta
Gita Ram
GR
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000209:etiology; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions; D004485:Eczema / Q000139:chemically induced / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods / Q000592:standards*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D014647:Varicose Ulcer / Q000139:chemically induced / Q000175:diagnosis* / Q000209:etiology
D004364:Pharmaceutical Preparations