title: Dimethyl fumarate contact dermatitis of the foot: an increasingly widespread disease.
abstract: BACKGROUND
  Dimethyl fumarate (DMF) has been recognized as an extremely potent irritant and sensitizer found in sachets inside furniture. The first skin manifestations were correlated to contact with sofas, chairs, and other furniture. In these last years, some papers have reported a development of allergic contact dermatitis on the foot caused by DMF present in high concentration in shoes made in China.
  
  
  METHODS
  We report the case of a 37-year-old woman who presented with severe eczema on the foot shortly after having bought a new pair of shoes. The diagnosis was performed by patch tests with DMF in several dilutions, with pieces of internal and external parts of the shoes, and by chemical analysis of the shoes.
  
  
  RESULTS
  In the last three years, goods containing DMF increased diffusely despite the augmentation on global preventive measures by Europe.
  
  
  CONCLUSIONS
  Therefore, new cases of contact dermatitis could be dependent on DMF, and it is of note that this allergen is not included in most series for patch testing.
authors.affiliation: Allergological and Occupational Dermatology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy.
authors.forename: Angelo Massimiliano
authors.initials: AM
authors.lastname: D'Erme
authors.forename: Andrea
authors.initials: A
authors.lastname: Bassi
authors.forename: Torello
authors.initials: T
authors.lastname: Lotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Gola
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003879:Dermatologic Agents / Q000009:adverse effects*; D000069462:Dimethyl Fumarate; D005260:Female; D005534:Foot Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D005650:Fumarates / Q000009:adverse effects*; D006801:Humans; D010328:Patch Tests; D012775:Shoes / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D003879:Dermatologic Agents; D005650:Fumarates; D000069462:Dimethyl Fumarate