DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20180299

Patch testing in hand eczema: a cross-sectional study from a teaching hospital of North India

Seema Qayoom, Suhail R. Rather, Kafeel Khan

Abstract


Background: Hand eczema is a common dermatological disorder in different occupational groups with multifactorial etiology. Patch Testing serves as an important tool for identifying responsible allergens.

Methods: The study was conducted in the Department of Dermatology, SKIMS-MCH, Srinagar for duration of one year from June 2016 to June 2017. Patients of either gender with hand eczema, aged 18 years and above, presenting to outpatient department were enrolled in the study. After taking informed written consent from patients, a detailed history was taken, and clinical examination was performed on first visit. Patch testing with Indian Standard Series was performed a fortnight after complete resolution of signs and symptoms of eczema and after complete withdrawal of the drugs.

Results: Out of 116 patients 60 (51.7%) were males and 56 (48.3%) were females. Male to female ratio was 1.07:1. Mean age of presentation of females was 35.42±12.52years and of males was 49.2±10.01years. The commonest allergen was Nickel sulphate (23.2%) followed by Potassium dichromate (15.1%). Nickel sulphate was most common allergen in females while Cobalt sulphate and Paraphenylene diamine were most common allergens in males. House wives (36.2%) and farmers (11.2%) were occupations with high frequency of hand eczema.

Conclusions: Patch testing in clinically diagnosed cases of hand eczema can play a vital role in not just the confirmation of the label but can also reduce the socio-economic burden on such patients.


Keywords


Gender, Hand Eczema, Occupation, Patch testing

Full Text:

PDF

References


Elston DM, Ahmed DD, Watsky KL, Schwarzenberger K. Hand dermatitis. J Am Acad Dermatol. 2002;47:291‑9.

Verhoeven EW, Kraaimaat FW, Kerkhof PC van de, van WC, Duller P, van d V, et al. Psychosocial well-being of patients with skin diseases in general practice. J Eur Acad Dermatol Venereol. 2007;21:662-8.

Meding B, Swanbeck G. Consequences of having hand eczema. Contact Dermatis. 1990;23:6.

Thyssen JP1, Johansen JD, Linneberg A, Menné T. The epidemiology of hand eczema in the general population-prevalence and main findings. Contact Dermatitis. 2010;62(2):75-87.

Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P, et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis. 2008;59(1):43-7.

Willan R. On Cutaneous Diseases. London, England: Johnson;1808.

Sarwar U, Asad F, Rani Z, Kurshid K, Pal SS. Frequency of allergic contact dermatitis in hand eczema patients with European standard and corticosteroid series. J Pak Assoc Dermatol. 2013;23(3):289-94.

Smith HR, Armstrong DK, Wakelin SH, Rycroft RJ, White IR, McFadden JP. Descriptive epidemiology of hand dermatitis at the St John’s contact dermatitis clinic 1983-97. Br J Dermatol. 2000;142:284-7.

Majid I. Contact allergens causing hand eczema in ethnic Kashmiri population: A study of 7-years. Indian J Dermatol. 2016;61(1):119.

Meding B, Jarvholm B. Incidence of hand eczema- a population based-retrospective study. J Invest Dermatol. 2004;122:873-7.

Bajaj AK, Saraswat A, Mukhija G, Rastogi S, Yadav S. Patch testing experience with 1000 patients. Ind J Dermatol Venereol Leprol. 2007;73(5):313.

Nielsen NH, Menne T. Allergic contact sensitization in an unselected Danish population. The Glostrup Allergy Study, Denmark. ActaDerm Venereol Suppl (Stockh). 1992;72:456-60.

Andersen KE, White IR, Goossens A. Allergens from the standard series. In: Frosch PJ, Menné T, Lepoittevin JP, editors. Contact dermatitis, 4th ed. New York. Springer;2006:455.

Mortz CG, Lauritsen JM, Bindslev-Jensen C, Andeersen KE. Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. Acta Derm Venereol Suppl (Stockh). 2002;82:359-64.

Schnuch A, Geier J, Uter W, Frosch PJ, Lehmacher W, Aberer W, et al. National rates and regional differences in sensitization to allergens of the standard series. Population adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK). Contact Dermatitis. 1997;37(5):200-9.

Meding B. Differences between the sexes with regard to skin related skin disease. Contact Dermatitis. 2000;43:65-71.

Kishore NB, Belliappa AD, Shetty NJ, Sukumar D, Ravi S. Hand eczema-Clinical patterns and role of patch testing. Indian J Dermatol Venereol Leprol. 2005;71:207-8.

Kaur S, Sharma VK. Contact dermatitis of hands in Chandigarh. Indian J Dermatol Venereol Leprol. 1987;53:103‑7.

Aneta L. European standard series patch test results from a contact dermatitis clinic in Israel during a 7-year period from 1998-2004. Contact Dermatitis. 2006;55:73-6.

Lam WS, Chan LY, Ho SCK, Chong LY, So WH, Wong TW. A retrospective study of 2585 patients patch tested with the European standard series in Hong Kong (1995-99). Int J Dermatol. 2008;47:128-33.

Khan MS, Rani Z, Ahmed ML, Hussain I, Kazmi AH. Evaluation and pattern of nickel dermatitis in patients with allergic contact dermatitis. J Pak Assoc Dermatol. 2005;15:136-9.

Handa S, Kaur I, Gupta T, Jindal R. Hand eczema: correlation of morphologic patterns, atopy, contact sensitization and disease severity. Ind J Dermatol Venereol Leprol. 2012;78:153-8.

Kishore NB, Belliappa AD, Shetty NJ, Sukumar D, Ravi S. Hand eczemaclinical patterns and role of patch testing. Ind J Dermatol Venereol Leprol. 2005;71:207-08.

Laxmisha C, Kumar S, Nath AK, Thappa DM. Patch testing in hand eczema at a tertiary care center. Indian J Dermatol Venereol Leprol. 2008;74:498-99.

Vigneshkarthik N, Ganguly S, Kuruvila S. Patch Test as a Diagnostic Tool in Hand Eczema. J Cli Diag Res. 2016;10(11):WC04-WC07.

Agarwal US, Besarwal RK, Gupta R, Agarwal P, Napalia S. Hand eczema. Indian J Dermatol. 2014;59:213-24.