CONTACT DERMATITIS TO FOOTWEAR
The chief causes here are the thermoplastic or rubber-boxed toes,
and the cements and dichromates used in tanning. Dyes, anti-mildew
agents, formaldehyde and nickel eyelets or nickel in arch supports
also can cause dermatitis. A waterproofing silicone spray externally
applied has also been the cause. The dermatitis usually begins on
the dorsa of the big toe and spreads to the dorsa of the foot. Atopic
children will often show a similar dermatitis which, however, will
have negative results on patch-tests to shoe ingredients. Sox washed
in Bold or bleached with a strong whitener can also cause dermatitis.
Safe sneakers are Converse (Official Boy Scout-Sears), although
you must rip out the rubber insole and replace it with the "Vy-Foam"
(urethane foam) insole (Dr. Scholl). weejuns (Bass) have no accelerator
in them.
While a patient with a shoe dermatitis is being evaluated, he should
wear sandals or unlined cloth or plastic shoes, which are inexpensive
and generally safe. Unlined moccasins also are fairly safe (L.L.
Bean deer hide). If the rubber-box toe is the cause, the Celastic
box toe (Celastic Box Toe Company, Kearney, N.D.) may be the answer.
Otherwise for men, Johnson & Murphy, French Shriner & Urner
and Stacy Adams make excellent shoes. For boys and girls, Gerberich-
Payne shoes contain the Celastic box toe, and "Little Yankee" makes
a nice shoe for boys.
Weejuns (Bass) are tanned with chromate though often successfully
worn. Dermapedic shoes are all vegetable tanned, and their glues
are vegetable based. They make men's and boys' boots and shoes.
Plastic-molded sandals for women may be obtained from Sandak. Kinney
plastic shoes are available in the Northeast. The Musebeck-Foot-So-Port
Shoe Co. (Oconomowoc, Wisconsin) makes a kit and has a catalog which
they will send to any physician requesting it.
Occasionally wearing down the heel pad or lining will expose adhesive
which will cause dermatitis. A felt insole and use of fish glue
will assist this. Doctor Fisher says Celastic box toe shoes do not
contain any phenolic or rubber adhesive (ref).
Formaldehyde is used in the tanning of white leather shoes in "elk,"
"white kid" and "new bucks." Tannins obtained from trees are used
to tan leather (vegetable tanning) and do not cause dermatitis.
However, if the shoe is made of vegetable-tanned leather, the lining
should not be chrome- tanned.
Dyes are not often the cause of footwear dermatitis unless the
shoe has been re-dyed (ref).
Management of Hyperhidrosis
Sweat leaches out chromates from the leather, so controlling perspiration
is essential. Zeasorb Powder (Stiefel) and Dr. Scholl's foot granules
in a soap are excellent for reducing some of this. Wearing Surgitube
under the sock and then throwing it away is helpful, too, and the
old-fashioned foot soaking in a teaspoon of formaldehyde in a pint
of water occasionally helps. The astringency of Burow's solution
soaks is helpful.
