Chronic Hand Dermatitis: Impact Of Patch Testing and Allergen Avoidance Post Treatment.
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Natalka Parzei, Stephanie Vakaljan, Bsc, Jason A. Ohayon, MD FRCPC
RATIONALE: Chronic hand dermatitis (CHD) negatively impacts patient’s quality of life (QOL), risking possible occupational abilities. Patch testing is used to identify allergic causes of CHD. The impact of allergy avoidance on CHD resolution is not well characterized.

METHODS: A retrospective chart review was carried out in a community Allergy office to assess effectiveness of allergen avoidance in maintaining remission of dermatitis in CHD. Patients were contacted by email for updates on their progress since diagnosis and counselling of their contact allergen. Patient demographics, occupation, allergens identified, treatment and impact of advice from American Contact Dermatitis Society-Contact Allergen Management Program (ACDS-CAMP) was collected.

RESULTS: A total of 30 CHD patients, (23–69 yrs) seen for patch testing between January 2014 - May 2017 responded to an email survey. The majority were female (19/30, 64%). Only 20% of allergens were linked to occupational exposure. Advice on allergen avoidance resulted in “significant improvement” in 50% (15/30) within 1 month, with another 27% (8/30) improving within 2 months, post completion of medical treatment. Propylene glycol (10/30), formaldehyde releasers (7/30) and nickel (7/30) were the most common allergens identified. Compliance to allergen avoidance was achievable in 90% of CHD with ACDS-CAMP helpful in 80% (24/30). Only 3 patients required a change of occupation.

CONCLUSIONS: In patients with CHD, avoidance of identified allergens from patch testing significantly improved patients QOL to allow continued occupation with minimal to no medical treatment required. Improvements were rapid and usually occurred within 2 months.