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

Dermatitis. 2022 Jan-Feb;33(1):62-69. doi: 10.1097/DER.0000000000000750.

Abstract

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.

MeSH terms

  • Adult
  • Allergens / adverse effects*
  • Coloring Agents / adverse effects
  • Cross-Sectional Studies
  • Dermatitis, Allergic Contact / diagnosis*
  • Dermatitis, Allergic Contact / etiology
  • Female
  • Foot Dermatoses / diagnosis*
  • Foot Dermatoses / etiology
  • Humans
  • Male
  • Middle Aged
  • North America
  • Patch Tests / methods
  • Resins, Synthetic / adverse effects
  • Retrospective Studies
  • Rubber / adverse effects
  • Shoes / adverse effects*
  • Young Adult

Substances

  • Allergens
  • Coloring Agents
  • Resins, Synthetic
  • p-tert-butylphenolformaldehyde resin
  • Rubber