ISPUB.COM The Internet Journal of Dermatology Volume 5 Number 1 1 of 5 Patch Testing In Cosmetic Dermatoses: A Report From South India A Nath, D Mohan Thappa Citation A Nath, D Mohan Thappa. Patch Testing In Cosmetic Dermatoses: A Report From South India. The Internet Journal of Dermatology. 2006 Volume 5 Number 1. Abstract Thirty five patients with cosmetic dermatoses were patch tested in this study. Out of 35 patients, 23 were female and 12 were male, with a female to male ratio of 1.9:1. Mean age of patients was 42 years. Kumkum was the incriminated cosmetic in 24 patients, sticker bindi in 5 patients, kumkum and sticker bindi both in 1 patient, hair dye in 3 patients, Fair & Lovely and aftershave lotion in 1 patient each. Out of 2380 patches applied, positive reactions were seen in 57 patches. Twenty eight out of 35 patients had positive (allergic) patch test reaction. Thimerosal showed positive reaction in 27 patients (27/35), gallate mix in 15 patients (15/35), paraphenylenediamine in five patients (5/35), nickel sulphate in two patients, and parabens, Kathon CG, benzotriazol, tertiary-butyl hydroquinone, quaternium-15, balsam of Peru, potassium dichromate and cobalt chloride in one patient each. INTRODUCTION Adverse cutaneous reactions due to cosmetics are because of the presence of four classes of ingredients – preservatives, emulsifiers, fragrances, and coloring agents. 1 Serious adverse effects caused by cosmetics are infrequent compared to their widespread use. 2 , 3 However, mild reactions such as itching, prickling, and dryness can occur in more than 10% of the adult population. 2 , 3 Most individuals who experience a cutaneous reaction to cosmetic usually have a mild reaction and simply change to another product, and only rarely is a reaction reported. 4 , 5 Since the clinical features of cosmetic dermatitis are more often mild or covert, patch testing should be done to confirm the diagnosis. 6 The aim of our study was to identify the allergens by patch testing in patients with dermatoses due to cosmetics. MATERIALS AND METHODS This was a descriptive study conducted in the dermatology department in JIPMER, Pondicherry (India) from August 2004 to June 2006. Patients with dermatoses due to the use of cosmetics and personal care products were included in the study. Patch testing was performed with the cosmetic allergens procured from Systopic® Pharmaceutical Ltd., India and the Indian Stanard series of allergens approved by Contact and Occupational Dermatoses Forum of India (CODFI). In patients with acute dermatitis, patch testing was postponed till the acute dermatitis subsided. Reading was done at 48 hours and 96 hours. In case of doubtful reactions, patients were advised to return on day 7. The grading system as followed by the North American Contact Dermatitis Group was used. 1 Ethical committee approval was obtained. RESULTS Thirty five patients with dermatoses due to cosmetics and personal care products were patch tested in our study. Twenty three were female and 12 were male. Female to male ratio was 1.9:1. Mean age of patients was 42 years. Frequency of positive patch test reaction was higher in females (82.6%) than in males (75%), but it was not statistically not significant (P=0.66 by Fisher's Exact test). Twenty four out of 35 patients (68.6%) had dematoses due to kumkum; sticker bindi was the responsilble cosmetic in five patients (14.3%); dermatosis due to both kumkum and sticker bindi was seen in one patient. Three cases (8.5%) of contact dermatitis due to hair dye; one due to Fair & Lovely; and one due to aftershave lotion were also seen. A total of 2380 patches were applied, and positive reactions were seen in 57 patches (2.4% of the patches applied). Overall, out of 57 patches which showed positive reactions, preservatives showed positive reaction in 30 patches (30/57, 52.6%), antioxidants in 15 patches (26.3%),