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Symmetric dermatitis on the dorsum of the feet suggests allergic contact dermatitis from footwear; it also should suggest the use of patch testing to determine the responsible allergen. Warshaw and co-workers sought to identify the frequency with which various allergens caused shoe dermatitis. They reviewed the records of 10,061 patients patch tested with the North American Contact Dermatitis Group (NACDG) standard screening panel at various sites between 2001 and 2004; 154 relevant allergic test reactions in 109 patients met the stringent inclusion criteria for footwear-associated allergic contact dermatitis.
The leather adhesive paratertiary butylphenol formaldehyde, the most common allergen, was identified in 25% of positive patch-test re…