Experience and feasibility of patch testing in allergic contact dermatitis in rural population

Context: The true incidence of allergic contact dermatitis (ACD) in a society is very difficult to estimate since its diagnosis depends on several factors. Patch testing is a useful tool to detect the allergens and improve the quality of life. Aims: The study was undertaken to determine the clinical pattern of ACD and find the causative allergen using patch test at a Rural Tertiary Care Center. Settings and Design: A 1-year study of 60 patients suspected with ACD was carried out at the Department of Dermatology. Demographic variables, clinical history, and examination were carried out. Subjects and Methods: Patch testing was done after a week of subsidence of active eczema utilizing the Indian Standard Series containing 20 allergens. Results were read on 2 nd and 3 rd day. Grading of the reactions was done based on the International Contact Dermatitis Research Group guidelines. Statistical Analysis Used: Descriptive analysis was used. Results: Of 60 patients, 60% were males and 40% were females. The most common site affected was hand in 56.66% followed by head and neck in 33.33% and feet in 21.66%. Positive result to patch test was seen in 51.33% patients. The most common allergen was Parthenium in 23.33% patients followed by fragrance mix in 11.66% patients. Grade 1 positivity was seen in 73.91%, 17.39% showed grade 2, 7.24% showed grade 3, and only 1.44% showed grade 4 positive reaction. Conclusions: In this era of urbanization and cosmetics, it is very important to keep the provisional diagnosis of ACD in all suspected cases of eczema, and a patch testing should be recommended. It helps in saving healthcare resources and decreasing the financial burden. Such studies at a large scale will help in establishing the prevalence of particular allergen in that area and help in spreading awareness in the community.