Shoe allergens in contact dermatitis

NewsBot · Nov 21, 2007

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Shoe allergens: retrospective analysis of cross-sectional data from the north american contact dermatitis group
Warshaw EM, Schram SE, Belsito DV, Deleo VA, Fowler JF Jr, Maibach HI, Marks JG Jr, Mathias CG, Pratt MD, Rietschel RL, Sasseville D, Storrs FJ, Taylor JS, Zug KA.
Dermatitis. 2007 Dec;18(4):191-202.

BACKGROUND: 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.

OBJECTIVES: 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.

METHODS: 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."

RESULTS: 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.

CONCLUSIONS: 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.
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NewsBot · Jul 8, 2014

Shoe Allergic Contact Dermatitis.
Matthys E, Zahir A, Ehrlich A.
Dermatitis. 2014 Jul 3.

Foot dermatitis is a widespread condition, affecting men and women of all ages. Because of the location, this condition may present as a debilitating problem to those who have it. Allergic contact dermatitis involving the feet is frequently due to shoes or socks. The allergens that cause shoe dermatitis can be found in any constituent of footwear, including rubber, adhesives, leather, dyes, metals, and medicaments. The goal of treatment is to identify and minimize contact with the offending allergen(s). The lack of product information released from shoe manufacturers and the continually changing trends in footwear present a challenge in treating this condition. The aim of this study is to review the current literature on allergic contact shoe dermatitis; clinical presentation, allergens, patch testing, and management will be discussed. PubMed and MEDLINE databases were used for the search, with a focus on literature updates from the last 15 years.
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NewsBot · Jan 18, 2015

Footwear contact dermatitis from dimethyl fumarate.
Švecová D, Šimaljakova M, Doležalová A.
Int J Dermatol. 2013 Jul;52(7):803-7. doi: 10.1111/j.1365-4632.2012.05512.x. Epub 2013 Feb 22.

BACKGROUND:
Dimethyl fumarate (DMF) is an effective inhibitor of mold growth. In very low concentrations, DMF is a potent sensitizer that can cause severe allergic contact dermatitis (ACD). It has been identified as the agent responsible for furniture contact dermatitis in Europe. The aim of this study was to evaluate patients in Slovakia with footwear ACD associated with DMF, with regard to clinical manifestations, patch test results, and results of chemical analysis of their footwear.
METHODS:
Nine patients with suspected footwear contact dermatitis underwent patch testing with the following allergens: samples of their own footwear, commercial DMF, the European baseline, shoe screening, textile and leather dye screening, and industrial biocides series. The results were recorded according to international guidelines. The content of DMF in footwear and anti-mold sachets was analyzed using gas chromatography and mass spectrometry.
RESULTS:
Acute ACD was observed in nine Caucasian female patients. All patients developed delayed sensitization, as demonstrated by positive patch testing using textile footwear lining. Seven patients were patch tested with 0.1% DMF, and all seven were positive. Chemical analysis of available footwear showed that DMF was present in very high concentrations (25-80 mg/Kg).
CONCLUSIONS:
Dimethyl fumarate is a new footwear allergen and was responsible for severe ACD in our patients. To avoid an increase in the number of cases, the already approved European preventive measures should be accepted and commonly employed.
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NewsBot · Feb 4, 2015

Contact allergy in Indonesian patients with foot eczema attributed to shoes.
Febriana SA, Soebono H, Coenraads PJ, Schuttelaar ML.
J Eur Acad Dermatol Venereol. 2015 Jan 30

BACKGROUND:
Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes. Allergens and types of shoes responsible may vary depending on manufacturing techniques, climatic conditions and indigenous traditions. This study focuses primarily on as yet unexplored shoe dermatitis cases in Indonesia.
OBJECTIVE:
To determine the prevalence of shoe dermatitis in the Dermatology outpatient clinic, Sardjito University Hospital, Yogyakarta, Indonesia over a period of 3 years and to identify the responsible allergens.
METHODS:
All patients meeting screening criteria for possible shoe contact dermatitis were patch tested with the European baseline series, shoe series and additional series based on earlier studies of Indonesian leather and shoe manufacturers; some were also patch tested with their own shoe materials and shoe extracts.
RESULTS:
Sixty-four (7.1%) of 903 patients with foot skin disorders were diagnosed with shoe dermatitis. Twenty-five (52.1%) of 48 patch-tested patients showed positive reactions to one or more allergens related to footwear. Sixteen patients were patch tested with their own shoe materials; 11 showed positive reactions. The most frequent relevant sensitizers were rubber allergens followed by preservatives, shoe adhesives and leather materials.
CONCLUSION:
Shoe dermatitis is common in Indonesia. Using three series of patch tests, we identified responsible allergens and patterns of sensitization in Indonesian shoe dermatitis patients.
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NewsBot · Jun 6, 2018

Footwear Contact Dermatitis: A Prospective
Cross-Sectional Study of 108 Outpatients
from Delhi, India
Farhan Rasool et al
SKINmed. 2018;16:90–97

Footwear contact dermatitis is a common problem with multifactorial exogenous, as well as endogenous, etiologies. Patch testing is the gold
standard for detection of the possible contactants. A cross-sectional study was conducted in 108 outpatients over a period of 18 months.
Demographic data comprising age, sex, and occupation were collected. Details of clinical and laboratory investigations were used to define the
incriminating ingredient(s), subsequently confirmed by patch test using Indian standard and footwear series approved by the Contact and
Occupational Dermatitis Forum of India. Reading and interpretation were carried out according to the International Contact Dermatitis
Research Group (ICDRG) guidelines. Of the 108 patients, 64 were girls or women and 44 boys or men. Although footwear contact dermatitis
affected all age groups, most individuals were 21 to 40 years old. The morphology and distribution of the lesions were very specific.
Patch testing was helpful, the primary sensitizing agent being mercapto mix, followed by mercaptobenzothiazole, potassium dichromate, and
paraphenylenediamine. Footwear contact dermatitis is an extraordinary entity, requiring a high level of expertise (or knowledge) to determine
its etiology through history, clinical examination, and patch testing.
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NewsBot · Jan 17, 2022

Shoe Allergens: A Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 2005-2018
Amber Reck Atwater et al
Dermatitis. 2022 Jan-Feb 01;33(1):62-69

Background: Shoe contact allergy can be difficult to diagnose and manage.

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.
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NewsBot · Aug 21, 2023

Programme for prevention of foot dermatoses in patients with work-related skin diseases: Baseline data and first results of a prospective cohort study (OCCUPES)
Richard Brans et al
Contact Dermatitis. 2023 Aug 20

Background: Programmes for prevention of hand dermatoses in patients with work-related skin diseases (WRSD) are well established. Similar interventions for foot dermatoses (FD) are widely missing.

Objective: To evaluate the effectiveness of a programme for prevention of FD based on health education in patients with WRSD while investigating the impact and possible causative factors of FD.

Methods: In a prospective cohort study (OCCUPES), 231 patients with WRSD and FD participating in the programme were recruited. The skin was examined and questionnaires were completed, including assessment of footwear, FD severity, symptoms and health-related quality of life.

Results: The baseline and some early results are presented. A work-related causation of FD was likely in 60 patients (26.0%) with irritant contact dermatitis being the most frequent diagnosis. Work-related FD were associated with male sex (p = 0.012), sweating in footwear (p = 0.004) and wearing of safety footwear (p = 0.013). FD were often long-lasting with a high degree of work-absenteeism, quality of life impairment, itch and pain, particularly in work-related FD.

Conclusions: Interventions are needed to reduce the burden of FD in patients with WRSD. The programme addresses current shortcomings in prevention of FD. A long-term evaluation of its effectiveness follows.
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NewsBot · Aug 21, 2023

A Classification of the Plantar Intrinsic Foot Muscles
Based on the Physiological Cross-Sectional Area and
Muscle Fiber Length in Healthy Young Adult Males
Yuki Kusagawa et al
Research Square

Background
Plantar intrinsic foot muscles (PIFMs) are composed of 10 muscles and play an essential role in achieving functional
diversity in the foot. Previous studies have identified that the morphological profiles of PIFMs vary between individuals.
The morphological profiles of a muscle theoretically reflect its output potentials: the physiological cross-sectional area
(PCSA) of a muscle is proportional to its maximum force generation, and the muscle fiber length (FL) is its shortening
velocity. This implies that the PCSA and FL may be useful variables for characterizing the functional diversity of the
individual PIFM. The purpose of this study was to examine how individual PIFMs can be classified based on their PCSA
and FL.
Methods
In 26 healthy young adult males, the muscle volume and muscle length of seven PIFMs (abductor hallucis, ABDH;
abductor digiti minimi, ABDM; adductor hallucis oblique head, ADDH-OH; ADDH transverse head, ADDH-TH; flexor
digitorum brevis, FDB; flexor hallucis brevis, FHB; quadratus plantae, QP) were measured using magnetic resonance
imaging. The PCSA and FL of each of the seven PIFMs were then estimated by combining the data measured from the
participants and those of muscle architectural parameters documented from cadavers in previous studies. A total of
182 data samples (26 participants × 7 muscles) were classified into clusters using k-means cluster analysis. The
optimal number of clusters was evaluated using the elbow method.
Results
The data samples of PIFMs were assigned to four clusters with different morphological profiles: ADDH-OH and FHB,
characterised by large PCSA and short FL (high force generation and slow shortening velocity potentials); ABDM and
FDB, moderate PCSA and moderate FL (moderate force generation and moderate shortening velocity potentials); QP,
moderate PCSA and long FL (moderate force generation and rapid shortening velocity potentials); ADDH-TH, small
PCSA and moderate FL (low force generation and moderate shortening velocity potentials). ABDH components were
assigned equivalently to the first and second clusters.
Conclusions
The approach adopted in this study may provide a novel perspective for interpreting the PIFMs’ function based on their
maximal force generation and shortening velocity potentials.
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