Patch Testing in Hand Eczema – Free Article!

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REVIEW of: The Efficacy of the Patch Test in Diagnosing Hand Eczema

Original article: Vigneshkarthik, N, Ganguly, S, and Kuruvila, S. Patch Test as a Diagnostic Tool in Hand Eczema. Journal of Clinical Diagnostic and Research, 2016; 10(11): WC04–WC07. India

Reviewed by Jacqueline Chen, BA. MSI and Brittanya Limone, MA. MSIII, Loma Linda University.

  • Hand eczema is a frequently encountered dermatologic problem that may be secondary to an allergic contact dermatitis (ACD). Patch testing is a diagnostic tool that can confirm an ACD etiology and determine the necessary allergens to avoid to prevent future exacerbations.
  • Vigneshkarthik, Ganguly, and Krurvila’s cross-sectional study analyzed patch test results to determine common allergens associated with ACD in patients with hand eczema. The study included 54 individuals, 27 men and women. The authors discovered that:
    • Of the patients with hand eczema 37% had positive patch test results to 25 different allergens, confirming that ACD is a common cause of hand eczema
    • Specific occupations were more susceptible including housewives, agriculturists, students and masons
  • Nickel was the most common allergen associated with hand eczema, particularly amongst patients with a vesicular hand eczema, or pompholyx, morphology.
    • In patients with nickel allergy, high levels of nickel in the diet have been associated with this more severe form of hand eczema.
  • Risk factors thought to be associated with the development of nickel hand eczema:
    • Ear piercings and adornment with nickel jewelry.
    • Chores in wet environments
    • Use of nickel-containing utensils
  • Detergents were another important association with nickel allergy
    • Over one-third of patients with regular detergent exposure had a positive patch test result.
      • 54% of these positive patch test results were due to nickel, either alone or in combination with cobalt sensitivity.
      • The association of nickel and cobalt allergies was determined to be due to co-exposure to the metals from a common source.

PubMed Link:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198439/   Adobe PDF Icon