Patch Testing in Hand and Foot Eczema Highlights Few Allergens
PATCH testing in hand and foot eczema frequently showed no allergen, yet potassium dichromate topped positive results overall here.
Study Design and Patch Test Approach
Investigators conducted a prospective observational study of 30 adults with hand and foot eczema in a tertiary care hospital setting over 18 months. Participants underwent patch testing using an Indian standard battery series with 20 antigens. Patch test chambers were applied to the upper back, and readings were taken at 48 hours and again at 72 hours, with interpretation using International Contact Dermatitis Research Group grading. Alongside patch test outcomes, the team documented clinical morphology, distribution, symptoms, and reported exposures relevant to hand and foot eczema.
Clinical Patterns, Symptoms, and Reported Exposures
The cohort included 18 males and 12 females, with the largest age group between 41–60 years. Hand eczema was the most common presentation, reported in 19 patients, while bilateral involvement was seen in 25 cases. Pruritus was nearly universal, and dryness was also frequently reported. In exposure histories, glove contact was the most commonly reported, followed by detergent exposure. Hyperkeratotic hand and foot eczema was the most frequently documented morphological pattern.
Patch Test Results and Practical Implications
More than half of patients had no positive antigens on patch testing. Among those with positive reactions, most had a single positive antigen, with fewer patients demonstrating multiple positives. Potassium dichromate was the most common antigen identified. The findings reinforce the challenge of hand and foot eczema as a chronic, multifactorial condition, while also underscoring the role of patch testing as a non-invasive tool to help identify a causative allergen when present. When an allergen is identified, targeted avoidance remains central to management and may be particularly relevant in cases linked to occupational or routine household exposures.
Reference: Balakumaran C et al. A Study Assessing Patch Test Results in Hand and Foot Eczema Patients at a Tertiary Care Hospital. Nigerian Postgraduate Medical Journal. 2026;33(2):285-288. doi:10.4103/npmj.npmj_167_25
Featured image: Віталій Б on Adobe Stock
