{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:51:46Z","timestamp":1791172306343,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Systemic contact dermatitis (SCD) occurs when sensitised individuals react to an allergen delivered systemically. Indian data that relate clinical patterns, patch\u2010test relevance and systemic exposures are limited.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n (i) Characterise the clinico\u2010demographic profile of four eczema patterns historically linked to SCD\u2014non\u2010specific eczema, pompholyx, recalcitrant hand eczema and symmetrical drug\u2010related intertriginous\u2010flexural exanthema (SDRIFE), and (ii) map probable systemic exposure pathways for the six allergens selected a priori based on their relevance in Indian patch\u2010test populations and their recognised or plausible systemic exposure pathways (para\u2010phenylenediamine, nickel, parthenium, potassium dichromate, cobalt and Balsam of Peru).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a prospective observational study at a tertiary care centre in North India from July 2023 to July 2024. Consecutive patients \u2265\u200912\u2009years with the target eczema patterns underwent detailed exposure history, Indian Standard Series patch testing and COADEX grading. Diagnosis of SCD required a relevant positive patch test, documented systemic exposure and temporal flare correlation. Oral provocation was not performed. Descriptive statistics were performed, with exploratory categorical comparisons using chi\u2010square or Fisher's exact tests, as appropriate.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n One hundred patients (mean\u2009\u00b1\u2009SD age 37.7\u2009\u00b1\u200914.7\u2009years; 59% female) were enrolled. Clinical distribution was non\u2010specific eczema 38%, pompholyx 32%, hand eczema 29% and SDRIFE\u2010like eruption 1%. Patch tests were positive in 40%, and leading sensitisers were para\u2010phenylenediamine 13%, nickel 9%, parthenium 9% and potassium dichromate 8%. Two women (2%; 95% CI 0.24%\u20137.04%) fulfilled the study's prespecified clinical criteria for SCD: one nickel\u2010associated case classified as clinically definite and one garlic\u2010associated case classified as probable. No SCD was diagnosed in pompholyx or hand eczema subgroups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although clinically relevant contact sensitisation is frequently observed, only two of 100 patients fulfilled the study's clinical criteria for SCD. These findings support targeted patch testing and structured exposure assessment in specific eczema patterns associated with SCD. Larger prospective multicentre studies are needed to refine criteria and capture the true burden of disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cod.70258","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:04:52Z","timestamp":1791169492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patch Test Relevance and Systemic Exposure Pathways in Eczema Patterns Suspected of Systemic Contact Dermatitis"],"prefix":"10.1111","author":[{"given":"Venus","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-1103","authenticated-orcid":false,"given":"Anuradha","family":"Bishnoi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipankar","family":"De","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7481-2330","authenticated-orcid":false,"given":"Hitaishi","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1486-7161","authenticated-orcid":false,"given":"Sanjeev","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.4103\/0378-6323.25633","article-title":"Systemic Contact Dermatitis","volume":"72","author":"Bajaj A.","year":"2006","journal-title":"Indian Journal of Dermatology, Venereology and Leprology"},{"issue":"3","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s12016-021-08873-2","article-title":"Systemic Contact Dermatitis: The Routes of Allergen Entry","volume":"61","author":"Pan Z.","year":"2021","journal-title":"Clinical Reviews in Allergy and Immunology"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.0105-1873.2006.00773.x","article-title":"Systemic Contact Dermatitis After Oral Exposure to Nickel: A Review With a Modified Meta\u2010Analysis","volume":"54","author":"Jensen C. S.","year":"2006","journal-title":"Contact Dermatitis"},{"issue":"5","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.0105-1873.2004.00400.x","article-title":"Parthenium Dermatitis: Is It a Systemic Contact Dermatitis or an Airborne Contact Dermatitis?","volume":"51","author":"Mahajan V. K.","year":"2004","journal-title":"Contact Dermatitis"},{"issue":"3","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1067\/mjd.2001.114738","article-title":"Balsam\u2010Related Systemic Contact Dermatitis","volume":"45","author":"Salam T. N.","year":"2001","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"4","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/cod.14496","article-title":"Old but Not Forgotten: Vesicular Hand Dermatitis From a Copper\u2010Containing Intrauterine Device","volume":"90","author":"George H.","year":"2024","journal-title":"Contact Dermatitis"},{"issue":"3","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/cod.14362","article-title":"Systemic Allergic Dermatitis to Cobalt Present in Cyanocobalamin Supplementation","volume":"89","author":"Pegalajar\u2010Garc\u00eda M. D.","year":"2023","journal-title":"Contact Dermatitis"},{"issue":"5","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.8877","article-title":"Symmetrical Cutaneous Rash in Two Women","volume":"12","author":"Orioni G.","year":"2024","journal-title":"Clinical Case Reports"},{"issue":"4","key":"e_1_2_10_10_1","first-page":"287","article-title":"Terminology of Contact Dermatitis","volume":"50","author":"Wilkinson D.","year":"1970","journal-title":"Acta Dermato\u2010Venereologica"},{"issue":"5","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1600-0536.1994.tb00603.x","article-title":"Garlic\u2010Induced Systemic Contact Dermatitis","volume":"30","author":"Burden A. D.","year":"1994","journal-title":"Contact Dermatitis"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12016-018-8686-z","article-title":"Systemic Contact Dermatitis","volume":"56","author":"Aquino M.","year":"2019","journal-title":"Clinical Reviews in Allergy and Immunology"},{"issue":"3","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.det.2009.05.005","article-title":"Systemic Contact Dermatitis","volume":"27","author":"Nijhawan R. I.","year":"2009","journal-title":"Dermatologic Clinics"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.4103\/0378-6323.77465","article-title":"Patch Test Results From a Contact Dermatitis Clinic in North India","volume":"77","author":"Handa S.","year":"2011","journal-title":"Indian Journal of Dermatology, Venereology and Leprology"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.4103\/idoj.IDOJ_768_20","article-title":"Clinical, Occupational and Allergological Profile of 455 Patients With Occupational Contact Dermatitis: A 5\u2010Year Study From a Tertiary Care Center of North India","volume":"12","author":"Mahajan V. K.","year":"2021","journal-title":"Indian Dermatology Online Journal"},{"issue":"12","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1001\/archderm.143.12.1504","article-title":"A 3\u2010Year Causative Study of Pompholyx in 120 Patients","volume":"143","author":"Guillet M. H.","year":"2007","journal-title":"Archives of Dermatology"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.4103\/0378-6323.35733","article-title":"Relationship Between Nickel Allergy and Diet","volume":"73","author":"Sharma A. D.","year":"2007","journal-title":"Indian Journal of Dermatology, Venereology and Leprology"}],"container-title":["Contact Dermatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cod.70258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cod.70258","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cod.70258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:04:57Z","timestamp":1791169497000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cod.70258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,4]]},"references-count":16,"alternative-id":["10.1111\/cod.70258"],"URL":"https:\/\/doi.org\/10.1111\/cod.70258","archive":["Portico"],"relation":{},"ISSN":["0105-1873","1600-0536"],"issn-type":[{"value":"0105-1873","type":"print"},{"value":"1600-0536","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,4]]},"assertion":[{"value":"2026-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cod.70258"}}