Shoe Allergens Research Articles

Shoe Allergens: A Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 2005-2018.

Shoe contact allergy can be difficult to diagnose and manage. The aim of the study was to characterize demographics, clinical characteristics, patch test results, and occupational data for the North American Contact Dermatitis Group patients with shoe contact allergy. This is a retrospective study of 33,661 patients, patch tested from 2005 to 2018, with a shoe source, foot as 1 of 3 sites of dermatitis, and final primary diagnosis of allergic contact dermatitis. Three hundred fifty-two patients met the inclusion criteria. They were more likely to be male (odds ratio = 3.36, confidence interval = 2.71-4.17) and less likely to be older than 40 years (odds ratio = 0.49, confidence interval = 0.40-0.61) compared with others with positive patch test reactions. The most common relevant North American Contact Dermatitis Group screening allergens were potassium dichromate (29.8%), p-tert-butylphenol formaldehyde resin (20.1%), thiuram mix (13.3%), mixed dialkyl thioureas (12.6%), and carba mix (12%). A total of 29.8% (105/352) had positive patch test reactions to supplemental allergens, and 12.2% (43/352) only had reactions to supplemental allergens. Shoe contact allergy was more common in younger and male patients. Potassium dichromate and p-tert-butylphenol formaldehyde resin were the top shoe allergens. Testing supplemental allergens, personal care products, and shoe components should be part of a comprehensive evaluation of suspected shoe contact allergy.

Foot contact dermatitis: nitrofurazone as the main cause in a retrospective, cross-sectional study over a 16-year period from Turkey.

The major causative agents in allergic contact dermatitis of the foot may differ from country to country. Sufficient data on foot eczema in patients from Turkey are lacking. To identify the clinically relevant contact allergens in foot eczema and determine the role of patch test series and patients' own materials in the detection of the responsible allergens. Among 1753 patients patch tested between 1996 and 2012 in our clinic, 53 with suspected allergic foot eczema were enrolled in this retrospective, cross-sectional study. Forty nine patients were patch tested with the extended European baseline series, 49 with supplemental series including rubber, leather, topical drugs, textile, cosmetic series containing preservatives and emulgators and varnish/plastic/glue series, and 37 with their own substances. Thirty of the 53 patch tested patients showing sensitization to at least one clinically relevant allergen were diagnosed with allergic foot eczema. The main eliciting agent was nitrofurazone (n = 8), followed by leather shoe allergens, ie, potassium dichromate (n = 6), p-tert-butylphenol formaldehyde resin and formaldehyde, in the second range. Rubber shoe allergens were less frequently observed (n = 3). In more than 1/3 of the patients, the causative agent could only be identified by testing the patient's own substances and/or supplemental series. Nitrofurazone was the leading causative agent followed by leather shoe allergens. Pediatric patients were frequently sensitized with shoe allergens. Patch testing with patient's own substances had a critical value in the detection of the causative agent in a significant number of patients.

Efficacy of New Barrier Socks in the Treatment of Foot Allergic Contact Dermatitis

The prevalence of allergic shoe dermatitis in patch-tested patients for foot dermatitis is reported in the literature to be in the range 3-24.2% (1, 2). It affects both sexes and any age group, including children. The most common shoe allergens reported are potassium dichromate, p-tertiary butylphenol formaldehyde resin, rubber chemicals and dyes present in leather tanning, rubber processing and adhesives. As nickel sulphate may be present in shoe buckles and studs, this may be considered a further shoe allergen (1-8). The warm and humid environment within the shoe provides an ideal situation for the development of allergic contact dermatitis (ACD), favouring both allergen dissemination and skin absorption. The first step in treating ACD is the removal of exposure to the causative allergens, but, for social, environmental or professional reasons (e.g. safety footwear or uniform), this may be difficult in the case of foot ACD. Textile engineering has recently developed socks made of a technological fabric Microair ® barrier (Al-pretec, Venice, Italy), a three-layer fabric designed to provide a physical barrier to allergens and irritants as well as high perspirability (9). The two external layers are made of a polyester microfibre with pique construction (fabric with a raised woven design) and the internal layer is made of a microporous membrane. This membrane is reported by the manufacturer to provide the fabric with total impermeability to liquids, ions and gas, and high wicking due to very high water vapour transmission rate (1062 g/m 2 /24 h). We studied the efficiency of these devices in a selected group of patients affected by ACD to footwear allergens.

Shoe Allergens: Retrospective Analysis of Cross-Sectional Data from the North American Contact Dermatitis Group, 2001-2004

Chemicals used in leather tanning, rubber processing, and/or adhesives are the most often-cited culprits in footwear dermatitis. Patch testing patients with suspected shoe dermatitis is essential for diagnosis and management. The four goals for this study were to (1) determine the frequency of allergens associated with a shoe source in North American Contact Dermatitis Group (NACDG) patients with footwear allergic contact dermatitis; (2) compare these results to allergen frequencies from other published studies; (3) quantify the number of shoe-related reactions that were not identified with the NACDG standard series; and (4) identify relevant allergens not included on the NACDG standard series, based on data from other published studies. The NACDG patch-tested 10,061 patients between 2001 and 2004. Data were retrospectively analyzed by (1) allergen source coded as "shoe," (2) site of dermatitis as "feet," and (3) diagnosis of "allergic contact dermatitis." Among the 109 NACDG patients with allergic contact dermatitis (ACD) of the foot and a shoe source of allergens, p-tertiary butylphenol formaldehyde resin, an adhesive, was the most common allergen, accounting for 24.7% of positive patch-test results, followed by potassium dichromate (17.5%) and carba mix (11.7%). When the data were examined according to groups of allergens, rubber chemicals (40.4%) were the most frequent allergens, followed by adhesives (32.5%), and leather components (20.1%). When data from published studies were pooled, potassium dichromate (31.5%) was the most frequent allergen, followed by p-tertiary butylphenol formaldehyde resin (17.1%) and cobalt chloride (12.9%). NACDG patients were statistically more likely to have positive patch-test reactions to p-tertiary butylphenol formaldehyde resin and statistically less likely to have a positive patch-test reaction to potassium dichromate than patients represented in pooled data from past studies. Nineteen (17.4%) of the 109 NACDG patients with ACD of the foot and a shoe source of allergens were identified as having a shoe source of a relevant allergen not included in the NACDG standard series. In NACDG patients, the most common individual shoe allergen was p-tertiary butylphenol formaldehyde resin. As a group, rubber chemicals were most common, a finding consistent with those of other studies.

Shoe Allergens: Review of the Literature and Retrospective Analysis of Cross-Sectional Data from the North American Contact Dermatitis Group 2001-2004

Warshaw, Erin M.; Schram, Sarah E.; Belsito, Donald V.; DeLeo, Vincent A.; Fowler, Joseph F. Jr.; Maibach, Howard I.; Marks, James G. Jr.; Mathias, Toby C.G.; Pratt, Melanie D.; Rietschel, Robert L.; Sasseville, Denis; Storrs, Frances J.; Taylor, James S.; Zug, Kathryn A. Author Information

Rubber Chemicals Are the Sole of Shoe Allergens

Rubber Chemicals Are the Sole of Shoe Allergens

Cr(III) reactivity and foot dermatitis in Cr(VI) positive patients

Chromium allergy has become synonymous with Cr(VI) allergy. However, real exposure to chromium from leather products may include both Cr(III) and Cr(VI). In this study, we investigate the reactivity to both Cr(VI) and Cr(III) in consecutive patients to analyse the relation between foot eczema/leather exposure and reactivity to Cr(III). From March 2002 to December 2004, 2211 consecutive patients with suspected allergic contact dermatitis were patch tested with 0.5% potassium dichromate (Cr(VI)) and 13% chromium trichloride (Cr(III)). A total of 71 (3.2%) patients had a positive reaction to Cr(VI), of which 31 also had a positive Cr(III) reaction. No Cr(VI) negative patients had a positive reaction to Cr(III). An increased risk of foot dermatitis was found in Cr(VI) positive patients with a concomitant positive or doubtful reaction to Cr(III) compared with Cr(VI) positive patients with no reactions to Cr(III). The increased risk was not due to a higher degree of sensitivity to Cr(VI). Leather was reported most frequently as the suspected cause of chromium dermatitis (54%). However, Cr(VI) allergics having foot eczema and positive or doubtful Cr(III) reactions often had positive reactions to other shoe allergens. Thus, Cr(III) allergy is part of a multiple shoe allergy pattern.

Foot dermatitis from the shoes.

Foot dermatitis from the shoes is a common disorder. Patients with foot complaints seen at the Contact Dermatitis Unit, Department of Dermatology, Gazi University Faculty of Medicine between May 2001 and May 2002 were evaluated. Four patients with foot dermatitis from shoe allergens were found. Their clinical and patch test results of shoe contact dermatitis were reviewed. We also summarized the standard test allergens for shoe dermatitis. All four patients were treated with topical corticosteroid creams and were informed about patch test-positive materials. Patients with foot dermatitis from shoes should undergo patch testing to exclude other causes of foot dermatosis. Contact dermatitis from shoes can be managed by the recognition and avoidance of the allergens responsible. The control of hyperhidrosis and the use of topical and systemic corticosteroid therapies may also be beneficial.

Common allergens in shoe dermatitis: our experience in Lahore, Pakistan.

Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes. Different chemicals, in conjunction with a hot and humid environment within the shoe, give rise to allergic or irritant dermatitis. Allergic shoe dermatitis is commonly caused by constituents of rubber, leather, adhesives, and rarely by linings and dyes. To determine the frequency of various allergens in shoe dermatitis in our patients. One hundred and nine patients suspected of having contact dermatitis due to shoe allergens were included. All patients were patch tested with the Shoe series and European Standard series. Patches were applied on the upper back and removed after 48 h. Results were read at 48, 72, and 120 h and interpreted according to International Contact Dermatitis Research Group (ICDRG) criteria. Of the 119 patients, 87 (73%) reacted positively to various allergens, 48% of whom showed polysensitivity. Glues (33.6%), particularly para-tert-butylphenol formaldehyde resin (PTBP-FR) (26.9%), were the leading cause of shoe dermatitis. Other allergens were leather chemicals (26.4%), potassium dichromate (16.18%), rubber allergens (7.6%), and dyes (7.6%). Shoe scrapings tested positive in 26.3% of patients. Other common allergens were nickel sulfate (22.7%), neomycin sulfate (10.1%), and cobalt chloride (8.4%). Considering the diversity of allergens, all patients presenting with shoe dermatitis should be patch tested with the Shoe series and a standard series to determine the etiologic allergens.

Common Shoe Allergens Undetected by Commercial Patch-Testing Kits: Dithiodimorpholine and Isocyanates

Common Shoe Allergens Undetected by Commercial Patch-Testing Kits: Dithiodimorpholine and Isocyanates

Common Shoe Allergens Undetected by Commercial Patch-Testing Kits: Dithiodimorpholine and Isocyanates

The diagnosis of allergic contact dermatitis of the feet is challenging because the constituents of shoes are not labeled. In addition, the materials and technologies used in the manufacturing of shoes are continuously evolving. Since the 1950s, rubber allergens have been the most common cause of shoe dermatitis. However, the causal allergens in rubber have changed. Instead of 2-mercaptobenzothiazole, dithiodimorpholine, an allergen that is not contained on standard patch-testing trays, now may be one of the more common rubber sensitizers in shoes. Other allergens not found on standard series that can account for shoe dermatitis include isophorone diisocyanate, dimethylaminoethyl ether, and mixed dialkyl thioureas. Therefore, physicians evaluating patients with allergic-appearing foot dermatitis need to test with allergens beyond those present on standard screening series.

Common Shoe Allergens Undetected by Commercial Patch-Testing Kits: Dithiodimorpholine and Isocyanates

Common Shoe Allergens Undetected by Commercial Patch-Testing Kits: Dithiodimorpholine and Isocyanates

Shoe dermatitis in India

105 patients with foot dermatitis, seen over a period of 18 months, were patch tested with various shoe allergens. 47 showed a positive reaction to 1 or more allergens. The majority of the cases (37-47) were chrome-positive. Positivity to plastic material was observed in 8, whereas rubber and rubber chemicals accounted for 5 cases. Of special interest were positive reactions to 1,3-diphenylguanidine in 3 and N-cyclohexyl-2-benzothiazolesulfenamide in 2 cases.