Clinical Evaluation of Suspected Cosmetic Contact Dermatitis and Association of Patch Test Positivity

BACKGROUND: Cosmetics are essential need of people and its use has increased dramtically over years. With increased usage comes increased adverse effects. The prevalence of cosmetic adverse reactions has become twice as compared to last decade. AIM: To determine the incidence of cosmetic adverse reactions among people attending Dermatology Contact dermatitis clinic and to analyze the association of various demographic factors, clinical patterns and patch test positivity. MATERIALS & METHODS: In this study, 131 patients with suspected cosmetic adverse reactions were recruited. History regarding demographic factors, symptoms & duration, Cosmetic product usage was elicited. A thorough clinical examination was conducted to know the clinical pattern & site of involvement. Patch test and photopatch test was done. RESULTS: In this study, the incidence of cosmetic adverse reactions was 12.83%. Females especially housewives between the age group of 51-60 years were predominantly affected. Hair dye and Kumkum were common product used and face was common site affected. Allergic contact dermatitis was the predominant pattern observed. 16 patients had Topical steroid damaged face (TSDF). The patch test postitvity rate was 7.04% and the common allergen was Paraphynelene diamine (PPD) followed by Fragrance and Kumkum. PPD positivity was also seen in Hair dye shampoo and Eyeliner products. CONCLUSION: Based on this study, the incidence of cosmetic adverse reactions shows increasing trend. The high prevalance of PPD positivity in this study waarants routine patch testing before commencing tha usage of cosmetic product conataining PPD. People should be made aware of these facts and physicians should be encouraged to perform patch test. The illegal use of excess concentration of ingredients should be checked and stringent laws for cosmetovigilance should be imposed to limit this increasing trend of cosmetic adverse reactions