:--..--?

_ "'=-'~AAO Research fellow (Urticaria)- Hospital del Mar, Barcelona, Spa,n

Deputy editor-Indian J Dermatology
 c tion
Introdu feet-->
foot
ca lized t o
n d sc aling) l o
( R e d ness a
t:L a t it is(FD)
• dDeer rmma t it is
a/w-
P atients t it is )
t e n th e s e
o t derma -
l types
O f d f o
-. and a n c a
d d e r r n atifis { h f F D - C l i n i
Han so on) ute
- -:. - - m o n e t io lo g ie o s t c. o m m • Ac e
m ( m
• Co r n a t it is acu.t
n t c o n tact d e r it is • Sub
:;-_Irrita dermat
~- - :_~- ..:: c t onic
• Chr
o n t a
llergic c
- - .;. A rrnatitls
- A topic de h o / y x J.
_
a t it is (PomP
rrn d e : m .
D y sh ydrog~yif_o
• E:p id e m io fo
3. 7%]
D 2 2 .9 %, H F o
) [H
FD (2.9%
kin A ll
M,1y 24 A tlas o f S
•Global
• • •• •
 ls te s t
e,ntca Pi¾tch
e. zlng ch
c t sit sensIH p tens)
n c o n ta

contac
td e rm a ti
ti s D e rm a
ti ti s o
Often s
pread.
(ha
ta n ts e
g. NoRe '
Al/r;-rg/c ct site._ Skin Ir ri n ts
n conta
ected
e
D e rm a
tt Hs o d e te rg sp
pread. it h s u
derma Htis
:ontact Rarefy s p r ic k W a ll y fo o d
Jrrit.mt< develop od P r ic k -
J, m a y
U rt k a r/ tf5- If exposure
s eg. fo e n ts ty
p ic
Protein ag
at1t1s rm a tt
co ntact derm in to d e
contmu
es
Protein st
a tc l) t e
t sites to
contac ed rning in re
Hs o n s als tc.1
Chetnic y U V e x p o s
u P h o to p
ntact De rm ~ ff
n light e
x po
erg;c co sb
Photoalf tftfs tn:linly o reas. h a p te n
dertna a
·
s like a
lim its, Look ky e
uc Ing c o n
ll -
Sharp m 4 y be strea aJs lnd
o n td c t
,
sunburn ) a n d bu//ous
. ChemJc d in fl a m m a ti
an
None
xic c
Phototo tts lants
(i f b y P n sun-expose
d damage V exposure,
dermat1 o at U
Appears areas
in sites
Hs a t sk /ca/s,
ct DermdH d b y Clothes. ing chem test
e con~ ere f Sens/Hz e a ir b o rn e Patch
Airborn n o t cov ce, d o rs u m o r
Which a
tis , fa
dermati eg . n eck
_hands

t /ng che
mlca/s P a tc h
test
ic c o n ta
ct
differen Sens/Hz . through the
System Hs Severa, ons. d e.g d Pero
ra,
absorbe
dermatt H
Presenta te m
Gt sys
B li n d e at1
P ro v oc 00

//
f Skin A 203.9
Atlas o Ac1,
A1ay2,1 Global erg½ fA
 demonic
dementitis
any do
r,@ >3 -
of Patchtest
pathomechanis-m
kenationste
monis naturere~ews disease primers
to potes
.

immunity
Fenate -

of
explorttonttnt" AboutthtJO\l1llal v pub11$h\\ith us v s11.bs<rll,t
. chemica l irritants (e.g.
detergents); No adaptive immunity,
· · • ization

Prim& 1~~27Mo,:t021

↑at t
ct -· · __ · _ ct ic T
ea s • esident Contact dermatitis
memor - - -.:;. _ J, previou ramela LScre'.M!3!l, MarcVve~~ Jacob P. 11-~~ Jeanne !NJS Johanse!l, Rosemary LNtl.:91} ta~
sensitiza • atory.- 9m, Nina C. Botto, Johanna Morot &Ari }.L Go'dmiro 8

i
Nature ~11ri\S Diseose ~1s 1, Mide number. 38 (2021) Cite th~ artld~

H83 Ate~ J 2 Gtations \ 1, Arlllletrlc \ Mtuks

IJDPlntinun-,Con 2oz4 6
 Ellctt otiOR
NctW e:<Po~uros
,co 5ooslt l%.Otl ol'l •t
I

~-•• •d h•P'" " or rooUII •~P" "u"'• I

t
physlc:<>ChOmteol propo<dOS J
of tho ~ptOO • 0,xposuro :
Olsrup tion of •pkld"f'l\al coo ctJ1Ior'l s. potyro o tphl sms t
t>.artief' ,-~ c~tl ~-si s .ind (!(lvrr·o omOf't ti.ll (octOf. S. l l(eCA ~lflo~ yte-
1 apc:">pto~iS Lo« '\ men ~rY.

• t{.;pt ~-Pro tof "-

com pla R
l• C fos-f"OSL.
csf<1tln
IL~'t.5 , l~-7.,
TO Fft. h41p tan
l p ~ ~"'tc-£l-CO:
l
..,•1

.
'•
Reso lutlo f1 of
•t tnfl.a tnTd& tion
t
-.
•• t

t
l l <D
@IL -l.0
T}
t
(
een.,.tar
t infittr atl<> n
t J9M CSo
lt! A )• ,'\
~(f)T.~1.1 MleU ~c~t lon of
T cell actlv atJon tL..-3 t , It.-33
! • Wlth h• 1SALTs
CXC L 10~ t rypo sc

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l
1
TNF
S•HT
01
IL'P'l7
.,fNy
M2
l
i f ---
'f:CL 2
MP1 2
•'
 must
proscribe
moisturizers
- PLG. mutation
and similar

May24

8
 clinical featur
• Redness, scaling, oo zi ng
• ac ut e, su ba cu te o+/- r eh r erna re p ro d u ci n g
e area of c ta c • leirgen..- •
•

=--~_:_==~==~=~~J
IJl)Plstln~mGa:n ~
20 24
9
 o~nc es ~ n
co pa
1rrttant
-

stinging, ikhing
- It in pain
Chronic Itching/pain EfVllierna pa.~u . . st~ scaling
Aalte aythema -4 vesicles -4 . • vesides erosions cru
i?rosionS crusts scaling Papules, plaques, sa,ling,
- .
Papules, plaqu~ fissures, ctU,stS
seating. crusts Sharp, conffned to site of ~.su re
~Margioation J\C\lte Sharl!,. strictlY confined spreading in the penP
- .hery;
#
- -

~sita to site of exposure ~ualf y ttny p,aputes;: mai beco me

-
- generatired
Chroriit~Jll-delined- ,,,, _ ft-defined.- w.reads
~EslciluuOJl AC!$- ~ k t { ~ ~ ewasurol • ot so rapid (12-72 h after exposure) l

~r00«:::1!MQl'lths tQ }'ea~Otrepeated exposure onths or longer; exacerbation after

every reexposure
-~~d -
~USq- .::tF ,._-;::__
enF ~ ~ent ratia n of agent RelatiVel indep -
endent of amou nt
-al!;. - f imf51-
-
ate Qfslijn barri,r; occurs onWf -
• I~ ~ery low
ons sufficient but depends
~lfoy e thresfiold level
-

- . ee of sensitization
-_- ~ly ev onl~ in the sensitized
- i(I __ ,
-

Derm atitis affec ting the dors um of feet --> ACD >>IC D

• n1Con 20 10
 -
•
-
-
• contact dermatitis
rsus afterg,c
·tis ve De
Comparison o f irrit.
an_c Allergic Conta
atitis (I
lnitant Contact Derm • - I•

__ _ ,_
.
-- -z
--... ;-
- -- ::: - ·~
-
-
,-c

~.
- --==--
.,..:-. = ,.,
- - - ,,. ~: -~ ~~ =- ::: :
-
mic stQroids
~-
;.--
--..
~~
~~

-- •
---- _--~. -• frrna- •
a

ists after allergen

20 24
UDP/atfnvmcon
it
_J
 • cUnlca\ prcsentotton
• exposure assessment
• Potch test

-~-~~~~:~J~:1~--:;~eg=
at~iv2c atoh teS-l

-1
1

sitTveP

• ExPo5UfCS to irntno
ts
_are identified and
quaot1fied
•l he a~ ur ec an .
explain the dennatit1s
J>ilrllyor fully
• Atemporal_relationshlp
~ ~1 $~ between expQS
~om"'' it h
h ._
UlCS
4 ... -,o the iro tm ll and
P,rotcios
g~ tl ltwic~\ly outbrc'3 b or severity
- PAC Jn food) of dormotitis
-
-=- --=
t i

~t lo nt es to
<> gs..patcb testing should • Tho diagnosis
ly"~-pertociood by expert~ n
nti, perforlll!dwi after carefurconsideratlon of iwentional requires aposttlvc.
ers under.suspicion r Jlt th testmg, $\ctn prlck or
\'et WS beoefit~
ilre also su1ted for skin In east of ch001lcols pr~sen photbpatc;h prick-prick tost to
ove on' produeu t In tostlng $hou\d
or.it pro\'Ocatlon rcs
tlng ca protein!. ot food
Sc he lnn 1a n et al,
erform~ hm,dled by the po tlont 20 21 , Na t.t Re v.
Pr im er
I
 A¤0 on tbe fee t is com mo nly c:a0sed
by allergens iA sho es and soc ks,
imcludimg ehro mat e, rub ber , tex tile s,
and adrnesives. J

t
wfth ~ruythc mb a
AO YCS1C105~ D U ~ r.-ctk>n

Schn1ldltn K Sanl S B
A Hands-on' Appr o~c:~ ~stel n DI, Fona-cter l.
and Patch Testl hg J All Cont act Derm atltts
1
Pract. 2020 Jun;s(G):i:s1~ ~ ~; lmm unol
1
IJOPlatln
 o eo
> Vol 11
, No 4 200, from t~e Nolth aVvynA
ft DE1W n al Data l an:tK
of, Cross- -Sectio
1
PublisM1 A

c tive An alysis
e
: R• =etrosp •
•
: -
/JergensO ~1
2001-20 J t. . /lMlf
f I.L
oe A
S.h_ , _ ' aN tis Grou p t · . a m ,s G. Matt,;
erm ati eo. -- -. ,, albad,_ J
Contact D 1\ - V 8'tsrto, v _ ,I A . o.,_ ._ _ . f Fowle,.k Ho
willll J M

American ,, S<ln.
and a
e foot
- 1~ S ..
- E~m
!f 9 4 4£nu
It W
t h
II> }
is ( A C D
) o f as the
r m a t it d h e s iv e , W
t de na d by
ll e r g ic contac h y d e r e s in , a lt s , f o l l o w e d
patients
w it h a o r m a ld
e st resu amine
N A CD G b u ty /p heno/ f it iv e P atch-te ata were ex ent
A ~ :~ :~
he 109 te r ti a r y % of po
s n the d t frequ
f a/Jergens, p g f o r 24. 7 (11.7%). W h e e r e t h e m o s n data
shoe sou
rce o
rgen , a ccou n ti n
c ar b a m ix ( 4 0 .4 % )W
2 0 . 1 % ). W h e
mon alle .5%). an
d emicals nents ( e most d
most com dichrof'[late (17 ens, r u b b e r ch t h e r c o m p o .5%) Was t h
le a 31 l%)
erg - in ( l 7 . o . ~n
m
potassiu
to g ro u ps o f all s (3 2 .5 %), a n d d ic h r o m a t e ( e r e s
g e d
accordin adhesiv otassiu
m a ld e h y. ,ve
- e ns,_ followed ?Y ere Pooled, P y f p h e n o / faol/r m ,
c
-
t o h a v e Pos,t s
rg
alle sw die ut
ary W b s ti
s ta ti li k e ly s
a / f y le
l,shed stu y PP·taetir ti ts ere y mor~ a t is t ic n t s
from Pub d b e--n s t
o w e n q
n P a t ie G
foll ). NACDG a
all:rgen2, .9 nof f o r e res,n
f r : qau e :lo e (1 % u ty fp h e t_dehy~ c h r o r n a t e t h a co
0 9 NA.
c nd r ti a r y b rn a
co lt .P ·te n to d1 1
-

n s t 9 a c ti o s s1 um f t h e
7.4%) o
st reacti o e
h-test r · P~ta
~atch-te a P o sitive Patcfrom Past t q . N in e t e e n (1
hav e ta Jes a
l,kebrto d in Poofed da t and a sh;eus ie s
re se n te e fo o d s e r
rep o f th tandar
With A c o AcoG S
Patients n e N
c n ;,
on-,
• IJOPfatln 0 024
.t s
"1avi4
 contact
oifEfierential oiagnt:15 •
to
who semitization
↑
••• v:-'---r'<

•• her: tY,pes. afi ec ema¢ der :·___,_~~. . . ,~~~lrt~lffffF ~';!l

test
to

patch
--,.--~ ___Asteatotic ec~erna ( d •
topic derm • • _ to
hydrotic eczern
pso
f
m
errn8t-itl
· cze in
Meritant

Ozunbun
-Stasisl~e--. -~
.._-.. ~--=- --- •
,-.;

space
= ~--
ttref~
=-
;::::_~~':::::::=.
=---=~~
uerm
~~~ ---
sor1asi
web
- ----=- -

foot⑦
~Gf- Toll
& .ef mails
'
I
- -
peti Adapted fron1 Ta
Amado, 2010 ylor and
 5 :3
Top ic•\ avo tda nc• of aue
roens and tn: tnn ts
1 t
filot cur ed
cured
Mo d...- or s_ .,. .. der tn• Cid S
Mtl d dern,.atJds

t Topfc_a\ ~ •~ nu
• As. for mil d den nat
Top ical u- ea ~n ~ 1t. mo w or p~ ~t ldJ . for, loc iili xed
qa lns < atr t,o m•4l se -
• Bia nd ernollicats wkh<>Ut .u•rv•I\S
idl Jllt i~ al t~ ~ eo nsl
Dl• dU
t•rY .-.m
. avo ~ln
lda SJ H11~a
nc• ntat>l• d< Wi ~ co n.: ain
• ToP-calcorttc:OSterokb • On ly If hig h de gre e oh u:t ill9 knc>Wl'l all .,: g• n
• Topical c.a dn. uri n lnh lbit OD - :ion o h : ~ flil tllH
PK
(pt m« aof mm . t11cmtmm S·
•T op ia l~ e_ t_ -~
l

'
4
l lrih ibi U{ ~ "l
_ Avo lda trtio rne nt_'bua -
nce axp osu ,.. Cu red No teu red
I
l
C~ No tcu red

+
Weig_h risk s and -"1 1•f lts
- of pbo toth er• PY

eu rcd No tcu red

s
M l!t I
•• S)°
:
ys ~m lc u1, mu nos un
.,p
•
ns,wn•uMor l
et b c c~l cos 111 1ro l&.
' + -
otr exa te ~ u n • mo d\J \a~ on•
Yl :O r•• ol ~ mo
• Az ath Jop rln e fet il
• ~l
• o~ ri ne -
Du plh ..-n a b

Ma y24
IJ0PletlnumCon 20 24

Schetnman et t
20 21, Na,r.. Rev~ Pirlm
1 .,1
~r
 +~~
atio n
age n •
O th e r
•

• io
el 1mial im 3 0
• milGI to sev,err:e
f

Bexaroterne gel
.

e , a r;eceisdmg. Q ai li
•
eeks
• Caldpotl'!iol- Bli> for, 8 w e _
• coal ta r (ilimited ev.iden
ee)
sumpleme iitli'i L a ct o b a ci llu s
Crisaborole (at op ic tMf) ill us ca se i a n d
•
11iii8itar) acidophilus, La ct ob ac n - e e ks ,
Delgocitinib (Ji>an JAK f1r
•
evi«;lemcef bacillus rhamno. •
• Fumarie acid (limited . s Q fO err
CS) i~A s a ch t -
• Retapamulin (~da~on T'-
• Bacteriafthera12y,- aEea
ro -
he. rnon- ~meiit irn at < ni i£
containing 5% Jysa rmIs
ter.i0m Vi tro sc i IIa fmf
"
pathogenic Oac •
sign~ficantl)f re du c~ tl fl e,
se ve ri ti a:n_ ..,
pr un tu • ff •:
,atGp.i-e lrl Ii )-
transep - r- ·oss ., • w

eu ~
colonisat it in i~ (a t0 JPiC HE}-
_'t:.

s
I, Australa J 1

IJDPlotinumCon 20 24
 ~-= -
.~. R. ~ ~-
.:::_-.
,...

~Qf]arrim·
~=--.. ,;;;;;.- =~
=-1!1~-
=- --
-=
•
--
 to
rubber Chinsam synthetic
chappals
if alleeric chappal ,

④ rubber
avoid
↳ TA -
punh
cotton
If Ned of foot-
lf!?= _13J socks Leolowing
white
alfor allengers
·
we
preventhte str ate gie s agent can

rubber
avoid stoes/pane
·

w:r1~n 1ntor:mat1Qn abollt

£ompUance
allergen$ (ACD)
Latin
Medtcal tteJtment

Informatton on ttand wash

lhfOml and, dlst n~n u
produ~

s -
tntorm,atfon on use of 1toyes

of
Be,toraffon of sRln barrier b~ use of
molsturlseJS and ~rsonal prottdi made
umstoes
equipment
#e P untennials
clothing
S

latova Las
O
A Pure use
Synthetic
May24 pot
dichromate
.
-
late
IJOPlatlnumC on 2024
4 r Global Mt,as
l I\ of sk·,n Atlerg v- l=A/1 rt • ?n1
I ?-0 o
 00 ,~' essases
rake o •
bTt tin urrin g
• Foot derma titis is a chron ic de I I a
dermatoses due • wear:-
Foot derma titis comm only occur s • •
•
a themes er po - - dtchro.,.,,a
1
te)
materials> socks.
>
-
· ) eat ~
1
i ' -

• Both rubbe r (thiur~ m mtx a • 5 _ • reap . benz othia zole

are Jmporta t sen
(MBT), PBD •
• ICD>ACD, AC _mpre . nvo ves t •
• Patch ·n all cases ths, c • out •
IGQ. terial s.
• Patch test . nclud e f
• Foot derma ti • • • atien t's
Qol.
• Avoidance of sensitizers--> corne rston e of mana geme nt.
• Emollients wjth-TCS/TCI,..-> 1st ~ineT/T, 2ncl, line "f/t-->
Rhototherapy, systemic immu nomo dulat ors, ?biol ogics

'
024 31
I