Allergic Reactions: Dermatitis From Old Sandal

A 3-year-old girl discovered lesions on her instep and great toe, where there was significant pressure from the old rubber sandals that she had been wearing. The contact dermatitis presumably developed because of the child's sensitivity to the combination of perspiration and the synthetic materials of the sandals. Because the footwear was significantly worn, the allergens were more easily leached out.

A simple method of establishing the diagnosis is to cut out a piece of the sandal that is in direct contact with the dermatitic skin and apply it as a patch test. The treatment, of course, is to have the patient stop wearing the sandals.

(Case and photograph courtesy of Wm. Lane M. Robson, MD, and Alexander K. C. Leung, MD.)