Two Cases of Shoe Dermatitis

Abstract

Case 1 : A 16-year-old male student developed itchy erythema, papules, vesicles, and scale on both soles of the feet in February 1981. The lesion aggravated gradually, especially in Summer. In June 1982, he visited our clinic. Itchy erythema, scale, crust, and exsudative lesions were present on the dorsum of the first three toes. Tests for fungus were negative. Patch tests using a piece of canvas shoe exhibited definite positive reactions. 10%, 1%, and 0. 1% of 18 rubber accelerators and 13 antioxidants in white petrolatum were patch Utsied. MBT, MMBT, CBS, and which have mercaptobenzo-thiazole structure as well as TMTD and TMTM which have dimethyl-dithiocarbamoyl structure produced moderately strong positive reactions. Other test substances did not produce any positive reactions. Rubber accelerators used in the shoes worn by the patient were chemically analyzed. MBTS was detected at levels of 173 ppm and suggested that MBTS or MBT was used as an accelerator in these shoes. Case 2 : A 51-year-old female office worker visited our clinic in August 1982 complaining of itchy, scaly erythema on the dorsum of toes and feet at the points where her feet came into contact with her shoes. She had a past history of leather watchband dermatitis in 1972. Patch tests using a piece of her leather sandal produced definite positive reactions. In the shoe patch test kit, only formaldehyde produced definite positive reactions. Interestingly, a black marking pen used to delineate the patch test sites after removal of the test materials produced eczematous reactions 24 hours later which persisted for over one week. Chemical analysis of her leather sandal and the marking pen yielded the following concentrations of formaldehyde : inner shoe material : 142 ppm ; outer shoe material : 401 ppm ; and 1, 930 ppm for the marking pen. Formaldehyde was thought to be responsible in this case. The causal chemicals responsible for canvas, rubber, and leather shoe dermatitis are discussed. © 1984, Meeting of Osaka Dermatological Association. All rights reserved.