Shoe Allergens: A Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 2005-2018


Amber Reck Atwater, From the Departments of Dermatology.
Raina Bembry, From the Departments of Dermatology.
Cynthia L. Green, Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC.
Joel G. DeKoven, Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
Erin M. Warshaw, Departments of Dermatology, Minneapolis Veterans Affairs Medical Center, Park Nicollet Health Services, and University of Minnesota, Minneapolis.
Donald V. Belsito, Department of Dermatology, Columbia University Irving Medical Center, New York, NY.
Howard I. Maibach, Department of Dermatology, University of California Medical School, San Francisco.
Jonathan I. Silverberg, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC.
James S. Taylor, Department of Dermatology, Cleveland Clinic Lerner College of Medicine, OH.
Margo J. Reeder, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison.
Kathryn A. Zug, Department of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Joseph F. Fowler, Division of Dermatology, University of Louisville, KY.
Melanie D. Pratt, Division of Dermatology, University of Ottawa, The Ottawa Hospital, Ontario.
Denis Sasseville, Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Quebec, Canada.
Vincent A. DeLeo, Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles.

Document Type

Journal Article

Publication Date



Dermatitis : contact, atopic, occupational, drug








BACKGROUND: Shoe contact allergy can be difficult to diagnose and manage. OBJECTIVE: The aim of the study was to characterize demographics, clinical characteristics, patch test results, and occupational data for the North American Contact Dermatitis Group patients with shoe contact allergy. METHODS: This is a retrospective study of 33,661 patients, patch tested from 2005 to 2018, with a shoe source, foot as 1 of 3 sites of dermatitis, and final primary diagnosis of allergic contact dermatitis. RESULTS: Three hundred fifty-two patients met the inclusion criteria. They were more likely to be male (odds ratio = 3.36, confidence interval = 2.71-4.17) and less likely to be older than 40 years (odds ratio = 0.49, confidence interval = 0.40-0.61) compared with others with positive patch test reactions. The most common relevant North American Contact Dermatitis Group screening allergens were potassium dichromate (29.8%), p-tert-butylphenol formaldehyde resin (20.1%), thiuram mix (13.3%), mixed dialkyl thioureas (12.6%), and carba mix (12%). A total of 29.8% (105/352) had positive patch test reactions to supplemental allergens, and 12.2% (43/352) only had reactions to supplemental allergens. CONCLUSIONS: Shoe contact allergy was more common in younger and male patients. Potassium dichromate and p-tert-butylphenol formaldehyde resin were the top shoe allergens. Testing supplemental allergens, personal care products, and shoe components should be part of a comprehensive evaluation of suspected shoe contact allergy.