Shoe allergy is fairly common and should be considered in all patients with chronic foot eczema. The main components of shoes include uppers/straps, soles, insoles, and heel and toe counters (stiff elements maintaining shape), all attached with adhesives. Allergy to rubber, leather, or adhesive as well as dyes and textiles found in shoes may cause allergic contact dermatitis of the feet, especially in patients with hyperhidrosis or personal history of atopy. The differential diagnosis of foot dermatitis is broad and includes psoriasis, tinea pedis, atopic eczema, irritant dermatitis, allergy to topical medicaments or nylon stockings, and in children, juvenile plantar dermatitis. Shoe allergy may appear superimposed on other dermatoses with patients sometimes having more than one diagnosis (e.g., both atopic and contact dermatitis) and more than one allergen (e.g., shoe component plus a topical medicament). Patch testing to the standard series, expanded shoe series, and physical pieces of the patient’s shoes is important for proper diagnosis. Prognosis in shoe allergy is good with allergen avoidance and substitution of hypoallergenic shoes or shoe components.
KeywordsShoe allergy Foot dermatitis Hypoallergenic shoes Patch testing Occlusive footwear Leather tanning Shoe dyes Para-tertiary-butylphenol formaldehyde resin (PTBPF-R) Thiurams Potassium dichromate Colophony Mercaptobenzothiazole (MBT) Dimethylfumarate P-phenylenediamine (PPDA)
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