DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20171569

Role of footwear allergens in juvenile plantar dermatosis

Shyni Perumbil, Kunnummal Muhammed, Sarita Sasidharan Pillai

Abstract


Background: Juvenile plantar dermatosis (JPD) is characterized by shiny dry fissured dermatitis of the plantar surface of the foot, affecting children aged 3-14years. The most accepted theory is that JPD is a frictional contact dermatitis of the forefoot in which atopics are more prone to develop. Allergic contact dermatitis remains a close differential diagnosis; it can aggravate the predisposing JPD. In this background we carried out a study among children aged fourteen years and below with clinically diagnosed JPD to know the age and sex profile, aggravating factors and clinical features in this part of the country.

Methods: All children aged 14 years and below with JPD attending our outpatient department from November 2006 to November 2007 were included in this study. Using a preset proforma, data regarding age and sex, information on any relation to footwear, past history of allergic disorders in person or family members was collected. All the 40 patients were patch tested using the footwear allergen series in petrolatum base. Patch test unit was removed after 48hours and the results were interpreted using criteria laid down by International Contact Dermatitis Group (ICDRG). The data was analyzed and made an attempt to understand the role of footwear allergy in JPD.

Results: 22 girls and 18 boys attended our OPD with JPD between the age group of 4-14 years. 52.5% were using footwear made of plastic; 25%used leather; 12.5% rubber footwear. Patients presented with erythema and glazed appearance of foot along with fissuring. The areas of involvement were distal soles and toes in 70%, distal sole alone in 7.5% and distal sole and dorsum of toes in 22.5% of patients. Personal history of atopy was documented in 15% of patients and family history of atopy was present in 20% of cases. 20% of patients complained of exacerbation with footwear. Of the 40 patients who underwent patch testing, 10% only showed positive patch test reaction mainly to potassium dichromate (5%).

Conclusions: JPD is not an uncommon disease and it predominantly affects school going children. Seasonal variation was associated with aggravation of disease. Specific footwear was identified to cause flare ups in a significant percentage of study population (20%) and this was proven by patch test results in half of them. Though nearly one fifth of the affected had an atopic diathesis in person or family, the present data suggests that JPD is not exclusive to atopics. A large sized study is required to evaluate the role of footwear in JPD.


Keywords


Juvenile plantar dermatosis, Patch testing, Allergens

Full Text:

PDF

References


Ashton RE, Griffith WA. Juvenile plantar dermatosis:Atopy or footwear? Clin Exp Dermatol. 1986;11;529-34.

Van Diggelen MW, Van Dijk E, Hawsman R. The engma of juvenile plantar dermatosis. Am J Dermatopathol. 1986;8:336–40.

Ashton RE, Jones RR, Griffiths A. Juvenile plantar dermatosis – A clinicopathologic study – Arch Dermatolol. 1985;121:225–8.

Lachapelle JN, Tennstedt D. A report of 80 cases. Am J Ind Medicine. 1985;8;291–5.

Verbor J. Juvenile plantar dermatosis [JPD]. Royal Liverpool Childrens Hospital, UK. Acta Derm Venerol Suppl. 1989;144:153- 4.

Lachapelle M, Maibach HI. Patch testing and prick testing: A practical guide or official publication of the ICDRG. Springer - Verlag Berlin Heidelberg; 2009.

Broberg A, Faergemann J. Scaly lesions on feet in children – tinea or eczema? Acta Pediatric Scand. 1990;79:349–51.

Kumar HK, Naveen S, Shankar K. Juvenile plantar dermatosis: A barrier disease beyond eczema: An open prospective uncontrolled study in a tertiary care hospital of South India. Indian J Paediatr Dermatol. 2016;17:13-7.

Brar KJ, Shenoi SD, Balachandran C, Mehta VR. Clinical profile of fore foot eczema. A study of 42 cases. Ind J Dermatol. 2005;71:179-81.

Jones SK, English JS, Forsyth A, Mackie RM. Juvenile plantar dermatosis- on 8 year follow up of 102 patients. Clin Exp Dermatol. 1987;12:5–7.

Kint A. Dermatitis plantaris sicca. Dermatologica. 1982;165:500–9.

Moorthy TT, Rajan VS. Juvenile plantar dermatosis in Singapore. Int J Dermatol. 1984;23:476-9.

Svensson A. Prognosis and atopic background of juvenile plantar dermatosis and gluteofemoral eczema. Acta Derm Venereol. 1988;68:336–40.

Zagne V, Fernandes NC, Cuzzi T. Histopathological Aspects of Juvenile Plantar Dermatosis. Am J Dermatopathol. 2014;36:359-61.

Weston JA, Hawkins K, Weston WL. Foot dermatitis in children. Pediatrics. 1983;72:824–7.

Fischer T, Maibach HI. Patch testing in allergic contact dermatitis. An update. Semin Dermatol. 1986;5:214–24.

Wahlberg JE, Wahlberg EN. Quantification of skin blood flow at patch test sites. Contact Dermatitis. 1987;17:229–33.

Bajaj AK, Gupta SC, Chatterjee AK, Singh KG. Shoe dermatitis in India. Contact Dermatitis. 1988;19:372–5.

Lear JT. English JC. Hand involvement in allergic contact dermatitis from mercaptobenzothiazole in shoes. Contact Dermatitis. 1996;34:432.