Patch test aids dermatitis prevention

This man has chronic hand dermatitis. For 15 years his finger tips would peel and his palms weep, requiring strong topical steroid creams and mupirocin cream combined. Soaps and detergents would act as non-specific irritants, meaning he had to wear rubber gloves with cotton inserts. Over time, the gloves made his hands flare up more. His patch testing above shows on the left a reaction to thiuram, a rubber accelerator. The positive reaction opposite this is colophony, the allergen in elastoplasts which he used to cover his weeping fingers. In time, he became allergic to them! All patients with chronic hand dermatitis should be patch-tested because the chronic peeling of the skin makes them liable to develop new allergies to things they come in contact with.

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