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CORRESPONDENCE
Year : 2012  |  Volume : 57  |  Issue : 5  |  Page : 409-410
Occupational allergic contact dermatitis: A clinical study in a tertiary care centre in central Kerala


Department of Dermatology & Venereology, Govt Medical College Thrissur, Kerala, India

Date of Web Publication3-Sep-2012

Correspondence Address:
Priya Prathap
Department of Dermatology & Venereology, Govt Medical College Thrissur, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.100508

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How to cite this article:
Prathap P, Kumar K A, Asokan N, Betsy, Binesh V G. Occupational allergic contact dermatitis: A clinical study in a tertiary care centre in central Kerala. Indian J Dermatol 2012;57:409-10

How to cite this URL:
Prathap P, Kumar K A, Asokan N, Betsy, Binesh V G. Occupational allergic contact dermatitis: A clinical study in a tertiary care centre in central Kerala. Indian J Dermatol [serial online] 2012 [cited 2019 Aug 24];57:409-10. Available from: http://www.e-ijd.org/text.asp?2012/57/5/409/100508


Sir,

Occupational allergic contact dermatitis (OACD) ranks first among all occupational diseases in many countries. [1] There have been only a few published studies on OACD from South India. So we decided to undertake a study with the aims of estimating the burden of OACD among patients with contact dermatitis (CD) attending our clinic and to identify the common allergens causing OACD in this population.

The study was approved by the Institutional ethical committee. Written informed consent was obtained from the patients. Socio-demographic variables were recorded in a specially designed proforma. Patch test was done with Indian Standard Series (ISS). Results were read after 48 hours and on sixth day. Statistical analysis was done using SPSS software.

One hundred and four consecutive patients who attended our CD clinic were studied [56 males (54%) and 48 females (46%)]. Mean age was 44.13 years. Patch test was positive in 70 patients (67%) after 48 hours. On reviewing the patients on sixth day, no late reaction was observed. Patch test positivity was considered clinically relevant in 60 patients. The allergen was found to be occupational in 47 of these patients (47/60; 78%) and they were diagnosed to have OACD.

Patients with OACD were further analyzed [Table 1]. There were 26 males (26/47; 55.3%) and 21 females (21/47; 44.7%). Among males, the common occupational groups affected were construction workers (18/26; 69%), drivers (2/26; 8%) and carpenters (2/26; 8%). Among females, house wives (11/21; 52%) were the most common group affected, followed by construction workers (7/21; 33%).
Table 1: Common allergens associated with OACD in our study


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The commonest allergen detected in our study was potassium dichromate (24/47; 51%) followed by fragrance mix (12/47; 25.5%) and parthenium (4/47; 8.5%). Sensitivity to multiple allergens was detected in seven patients (7/47; 15%).

A study done in Chandigarh also had identified potassium dichromate as the commonest allergen. [2] High prevalence of sensitivity to potassium dichromate is probably explained by the current construction boom in this part of the world. Parthenium was the commonest sensitizer recognized in studies conducted in Delhi and Pune. [3],[4] Differences in the pattern of allergens are probably due to the differences in the distribution of various natural allergens as well as factors related to occupation and life style of the population.

Detergents might be the occupational source for fragrance among house wives in our study because most of them, belonging to low socioeconomic status group, were not in the habit of using any cosmetics.

Parthenium is not a common plant in our place. The four patients with parthenium sensitivity developed dermatitis when they went for work in areas where the plant was commonly present.

Thus OACD plays an important role among patients with CD. Counselling and educating the patients about the allergens, their possible sources and about any cross-reacting substances could help to reduce morbidity due to OACD. In Western countries, addition of ferrous sulphate to cement, which converts hexavalent chromium into less sensitising trivalent form, has resulted in a sharp decline in the incidence of OACD among construction workers. [5] The feasibility of this step could be tried in our country also.

 
   References Top

1.Diepgen TL, Coenraads PJ. The epidemiology of occupational contact dermatitis. Int Arch Occup Environ Health 1999;72:496-506.  Back to cited text no. 1
[PUBMED]    
2.SharmaVK, Chakrabarti A. Common contact sensitizers in Chandigarh, India. A study of 200 patients with the European standard series. Contact Dermatitis 1998;38:127-31.  Back to cited text no. 2
    
3.Singhal V, Reddy BS. Common contact sensitizers in Delhi. J Dermatol 2000;27:440-5.  Back to cited text no. 3
[PUBMED]    
4.Sayal SK, Das L, Kumar A. Study of clinical profile of allergic contact dermatitis in Pune. Indian J Dermatol 1999;44:108-11.   Back to cited text no. 4
    
5. Zachariae CO, Agner T, Menne T. Chromium allergy in consecutive patients in a country where ferrous sulphate has been added to cement since 1981. Contact Dermatitis 1996;35:83-5.  Back to cited text no. 5
    



 
 
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