Patch Test as a Helping Hand in Farmers with Hand Eczema

Background: Farmers are particularly exposed to a large number of allergens including fertilizers, plant allergens, soil, and manure which may be aggravated by sun exposure. Hand eczema can cause significant morbidity affecting the patient’s occupational work. Patch test is an important diagnostic tool in differentiating between irritant contact dermatitis and allergic contact dermatitis and in the latter, to identify the culprit allergen causing hand eczema. Aims: This study aimed to identify the role of patch tests in hand eczema in farmers and to identify the common causative allergens of hand eczema in farmers. Materials and Methods: Fifty farmers aged 18 years and above presenting with hand eczema were enrolled in the study after taking approval from the institutional ethics committee. Patients who were pregnant, lactating, on systemic steroids, and immunosuppressants were excluded from the study. Patch test was done using the Indian Standard series of 20 allergens approved by the Contact Dermatoses Forum of India applied to the back of the patient. The first reading was taken at 48 h, 30 min after removal of the patch, and another reading was taken at 96 h. The results were interpreted according to the International Contact Dermatitis Research Group criteria. Results: Out of 50 patients, there were 28 males and 22 females. Hyperkeratotic eczema was the most common morphology (38%). The most common allergen was parthenium (44%) followed by potassium dichromate (22.7%) and nickel (9%). Limitations: A larger sample size would have helped to better substantiate the findings of the study. Conclusion: There is an undeniable relationship with the occupation of the individual wherein agriculturists and masons had the maximum predisposition. The most common cause of hand eczema in this study was parthenium in farmers and also other allergens played an important role such as potassium dichromate, nickel, and paraphenylenediamine.