Abstract
Background: Hand eczema is a common condition encountered in dermatology. It is caused due to various endogenous and exogenous factors. Various morphological forms of hand eczema have been described. Patch testing is the standard method to identify the allergen responsible for the eczema.
Aims: To find out the proportion of patch test positivity in hand eczema patients and to find out the most common allergen in hand eczema. The secondary objective was to study the morphological pattern of hand eczema.
Materials & Methods: This was a cross-sectional study involving 56 hand eczema patients conducted between January 2016 and December 2016, at a tertiary care centre in Southern India. After a detailed history including history of occupational exposure and detailed examination, patch test was done on these patients with Indian standard series. The patches were removed after 48 hours. Another reading was taken after 96 hours. The readings were interpreted according to International Contact Dermatitis Research Group criteria and noted down. The data collected were analysed in terms of descriptive statistics.
Results: Majority of the patients belonged to the group of housewives (28.6%) and masons (23.2%). Most of the patients had a non-specific morphological pattern of hand eczema (66.1%) followed by wear and tear dermatitis (16.1%). Patch test positivity was seen in 60.7% of the patients and the most common allergen was potassium dichromate (20.8%) followed by nickel sulphate (17%) and thiuram mix (15.1%). A high degree of clinical correlation could be made out between the allergens positive and allergen suspected (82.3%).
Conclusions: Hand eczema most commonly involved housewives and masons. Patch testing helped in finding out the suspected allergens in majority of the patients thereby enabling a holistic management of the patients with hand eczema.
Keywords: hand eczema, contact dermatitis, patch test.
References
1. Berth-Jones J. Eczema, Lichenification, Prurigo and Erythroderma. In: Burns T, Breathnach S, Cox N, Griffiths C. editors. Rook’s Textbook of Dermatology. 8th ed.Oxford: Wiley-Blackwell; 2010; p.23.1-23.51.
- Handa S, Kaur I, Gupta T, Jindal R. Hand eczema: Correlation of morphologic patterns, atopy, contact sensitization and disease severity. Indian J DermatolVenereolLeprol 2012;78:153-8.
- Agarwal US, Besarwal RK, Gupta R, Agarwal P, Napalia S. Hand Eczema. Indian J Dermatol 2014;59:213-224.
- Samahy MH, Kerdani T. Value of patch testing in atopic dermatitis. Am J Contact Dermat 1997;8:154-7.
- Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P,et al. Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: A multi-centre study. Contact Dermatitis 2009;61:291-6.
- Laxmisha C, Kumar S, Nath AK, Thappa DM. Patch testing in hand eczema at a tertiary care center. Indian J Dermatol Venereol Leprol 2008;74:498-9.
- Charan UP, Peter CVD, Pulimood SA. Impact of hand eczema severity on quality of life. Indian Dermatol Online J 2013;4:102-5.
- Majid I. Contact allergens causing hand eczema in ethnic Kashmiri population: A study of 7-years. Indian J Dermatol 2016;61:119.
- Suman M, Reddy BS. Pattern of contact sensitivity in Indian patients with hand eczema. J Dermatol 2003;30:649-54.
- VigneshkarthikN, Ganguly S, Kuruvila S. Patch Test as a Diagnostic Tool in Hand Eczema. J ClinDiagn Res 2016;10:WC04-WC07.
- Bryld LE, Agner T, Menné T. Relation between vesicular eruptions on the hands and tinea pedis, atopic dermatitis and nickel allergy. ActaDermVenereol 2003;83:186-8.
- Narendra G, Srnivas CR. Patch testing with Indian standard series. Indian J DermatolVenereolLeprol 2002;68:281-2.
- Kishore NB, Belliappa AD, Shetty NJ, Sukumar D, Ravi S. Hand eczema-Clinical patterns and role of patch testing. Indian J DermatolVenereolLeprol 2005;71:207-8.
- Trehan A, Singh K, Kanodia S, Verma AS. Contact hypersensitivity in hand eczema- a study with Indian standard series of allergens. Med Int Med J 2014;1:304-9.
- Treudler R, Richter G, Geier J, Schnuch A, Orfanos CE, Tebbe B. Increase in sensitization to oil of turpentine: recent data from a Multicenter Study on 45,005 patients from the German-Austrian Information Network of Departments of Dermatology (IVDK). Contact Dermatitis 2000;42:68-73.
- Barchino-Ortiz L, Cabeza-Martinez R, Leis-Dosil VM, Suárez-Fernández RM, Lazaro-Ochaita P. Allergic contact hobby dermatitis from turpentine. Allergol Immunopathol 2008;36:117-9.
Corresponding Author
Reena Chandran
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