An epidemiological study on the causative agents of footwear dermatitis in 90 patients

Background: Footwear dermatitis may be defined as skin manifestations on the feet precipitated by the wearing of shoes, boots or sandals. It is a CD4-T lymphocyte mediated type-4 hypersensitivity reaction eventually culminating in cutaneous inflammatory changes. Patch test provides precise and simple means for diagnosis and helps the physician to initiate appropriate management at the earliest. An attempt was made to study the common causative allergens of Footwear dermatitis and its epidemiological relevance as it would prove beneficial in the treatment. Materials and methods: Patients with the signs and symptoms of footwear dermatitis were selected, detailed history and presenting complaints were taken and recorded in a prepared case record form. Patch test kit recommended by the Contact and Occupational Dermatoses Forum of India (CODFI) which contains 20 antigens of standard footwear series wasused. Results were graded and statistical analysis was done. Results: The common allergens found on analyzing the patch test result was found to be Nickel Sulphate (63.3 %), Black rubber mix (61.1%), Cobalt Sulphate (60.1%) Potassium bichromate(61.0%), Chlorocresol (54%)and Paraphenyldiamine (28.9%). Discussion and Conclusion: Footwear dermatitis is one of the most misdiagnosed or empirically diagnosed skin ailment in majority of dermatological OPD’s. Employment of patch test will provide a resolution for this delinquent. Most common allergens found in the study were Nickel Sulphate and Black rubber mix.