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Background: There is a strong need to develop a photopatch test tray suitable for Indian patients of photodermatitis as European/Scandinavian photopatch test trays may not be wholly relevant for them. Aim: We carried out this study using photoallergens relevant in the Indian context to determine their relevance in patients of photodermatitis. Methods: Thirty patients (M:F, 23:7) between 19 and 76 years of age of photodermatitis and 10 controls were patch- and photopatch tested with 20 common photoallergens. In addition, the patients were also (photo) patch tested with articles of daily use as and when these were suspected to be the cause. Results: Forty-three positive reactions to one or more antigens were seen in 22 (74%) patients. Fourteen positive photopatch tests to seven allergens were observed in 10 (33%) patients, and nine (30%) of them had a definite relevance. The most common contact allergen was fragrance mix (FM) (30%), followed by p-phenylenediamine (20%) and Parthenium hysterophorous (17%). The definite relevance of the patch- and photopatch tests could be correlated in 47% of these patients. Conclusions: FM is the most common contact and photocontact allergen among the various photopatch test antigens. Although differences in technique and evaluation make direct comparison between different centers difficult, still photopatch testing remains an integral part and gold standard for the work-up of the photosensitive patients.
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Objective: This study sought to determine through patch testing the ten most common allergens among patients with suspected allergic contact dermatitis (ACD) and thus, provide dermatologists with a useful guide in patient evaluation and counseling regarding the avoidance of triggering factors that perpetuate their allergic skin problemsDesign: An observational desriptive studySetting: Tertiary government hospitalPatients: A total of 119 patients who presented with skin lesions at the outpatient section of the JRRMMC Dermatology Department from July 1991-June 1995 were patch tested. From these, 80 patients diagnosed to have ACD were given emphasis in the final analysis and evaluationResults: Of the total 119 patients patch tested during this 4-year time period, 80 patients (67.22%) were clinically diagnosed to have allergic contact dermatitis. The sites of dermatitis commonly affected in this group were the feet, the hands and the arms. the ten most common skin sensitizers identified among these patients were as folows: fragrance mix, nickel sulfate, potassium dichromate and thiurum mix-both at third, p-phenylenediamine, cinnamic aldehyde, balsam of Peru, epoxy resin and paraben mix-both at seventh, carba rubber mix, bronopol and 2-mercaptobenzothiazole both at ninth, wool alcohol and mercapto-mix sharing the tenth place. It is interesting to note that the top five allergens in this group share similar ranking to that which figured prominently among patients who exhibited various kinds of dermatitidesConclusions: As the result of rapid industrialization, the incidence of ACD has risen to the leaping proportion in the last two decades. Definite cure is obtained primarily by avoidance of the specific allergen(s). These are best indentified through patch testing. By undertaking this study, the authors hope to provide some local statistics on the most common skin sensitizers causing the ACD and therefore, place physicians and dermatologists in particular, in a better position to give their patients sound advice regarding the avoidance of tigerring factors that can readily perpetuate their skin problems.(Author)
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63 of 348 patients patch tested with an European standard series, had positive reaction to either a fragrance mix or Balsam of Peru. Twelve showed positiv reaction to bot,h patches. The number of positive patch tests to the fragrance mix was 56, while those to Balsarn of Peru was 19 out, of the 63 patients, manifesting sensitivities of 83% and 30% repectively. The fragrance mix was considered a useful screening patch for fragrance allergies. Twenty-five of the patients showing fragrance allergy were further analysed with 8 individual fragrance ingredients at 2% petrolatum. Cinnamic aldehyde and cinnamic alcohol were considered as she most frequent and important. sensitizers.