If the shoe fits, wear it?

Here the diagnosis of a shoe contact dermatitis is more likely when you correlate the distribution of the rash with the patient’s favourite shoes. The likely allergen is either potassium dichromate used in tanning the shoe leather or glues used in the shoe. In an old shoe, the lining is often worn through and either the glues or the potassium dichromate can leach through to the skin. The patient requires patch testing to determine the relevant allergen. In addition, a steroid cream and instructions to buy new shoes can work wonders.