Allergic contact dermatitis caused by exfoliating socks

A 45-year-old atopic woman, who worked as dental hygienist, was referred to us by a dermatologist for further patch testing because of an eczematous reaction after the use of exfoliating socks. The history revealed the use of ‘Footner® exfoliating socks’ (Nordic Consumer Health, Nacka Strand, Sweden) for 1 h on both feet as indicated in the instructions; afterwards, the patient had applied a bland moisturizer. She had used the same product three times before, once a year, but had never experienced similar symptoms until the current usage. The lesions, which became progressively worse, appeared the day after application of the socks (Fig. 1). At presentation in the referring dermatologist’s office, 1 week after the application of the socks, erythematous, oedematous and scaly plaques were seen on the dorsal aspects of the feet, and also on the plantar surfaces, according to the referring dermatologist. She was patch tested with the Swedish baseline series, and reacted positively to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), nickel sulfate, and Myroxylon pereirae resin. After she had been treated with potent topical corticosteroids under occlusion, healing was eventually achieved. Because of the adverse reaction to the socks, the patient contacted the company, and was informed that all parabens and fragrances had been