26. The Role of Patch Testing for the Evaluation of Adult Patients with Hand Dermatitis: A Retrospective Cohort Study

Introduction: Hand dermatitis is a common dermatologic condition with a lifetime prevalence estimated to be 20%. The objective of this study was to assess the demographics and patch test positivity in adult patients who underwent patch testing at our institution with a focus on patients with hand dermatitis. We hypothesize that tobacco smoking is a risk factor for hand dermatitis.

Methods: After IRB approval, a retrospective analysis was performed of subjects who underwent patch testing between May 2015-May 2020 at Saint Louis University’s Department of Dermatology using the North American Comprehensive patch testing series. Demographic information, location of rash, duration of rash before initial presentation, patch test results, tobacco smoking history, and occupation were obtained from chart review and collected using a REDCap database. Three subgroups were analyzed including subjects with hand only involvement of their dermatitis, subjects with hand plus other body site involvement, and subjects with no hand involvement. Chi-square test was used for statistical analysis.

Results: The most commonly positive allergens overall at our institution were nickel (31%), Balsam of Peru (30.6%), cobalt (29.5%), methylisothiazolinone (28.3%), and hydroperoxides of linalool (25.6%). Patients with hand only dermatitis were more likely to have patch positive tests to methylisothiazolinone (37.3%; p=0.03), Cl+Me-isothiazolinone (Kathon CG, 100ppm) (25.3%; p=0.03), 2-hydroxyethyl methacrylate (HEMA) (10.7%; p=0.05), and 4-chloro 3,5-xylenol (PCMX).

Impact: The results from this study will be important for counseling patients with allergic contact dermatitis as tobacco use may be a modifiable risk factor for their condition. The results will also aid providers in counseling their patients with hand dermatitis regarding chemicals and products to avoid that may improve their dermatitis.

Organization – Saint Louis University

Morris GM, Ong SK, Li Y, Bauman TM, Chrusciel T, Burkemper NM