1. What data in particular will be shared?
   Response - All of the individual participant data collected during the trial, after de-identification.
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response -  Statistical Analysis Plan
   Response - Informed Consent Form
   Response - Clinical Study Report
   
   
3. Who will be able to view these files?
   Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.
   


4. For what types of analyses will this data be available?
   Response - To achieve aims in the approved proposal.
   


5. By what mechanism will data be made available?
   Response - Proposals should be directed to [shatabdeesssahoo@gmail.com].
   


6. For how long will this data be available start date provided 25-03-2026 and end date provided 25-03-2029?
   Response - Beginning 3 months and ending 5 years following article publication.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - NIL

Hand foot dermatitis that includes atopic dermatitis and contact dermatitis, is common in children. Dermatitis presenting with atypical distribution or dermatitis that is recalcitrant or worsening despite topical treatment should raise clinical suspicion for ACD and referral for patch testing is recommended.

A good clinical evaluation of allergic contact dermatitis involves a detailed history and physical examination. The morphology and location of the dermatitis is often the best indicator of the offending agent.

Epidemiology- Among children with suspected contact dermatitis referred for patch testing, positive patch test rates have ranged from 14% to 70%. In contrast, there are some population-based patch test studies of unselected pediatric patients (sample size 85–1,146 patients per study), where positive patch test rates ranged from 13% to 24%, significantly lower than the rates seen in patients selected for suspected contact dermatitis. The largest of these studies, which also provides specific relevance information, found the prevalence of past or current relevant reactions to be 7%, with a higher risk seen in females.

Pathophysiology- Allergic contact dermatitis starts with the contact of the allergen to the skin. ACD is a delayed-type IV hypersensitivity reaction that occurs with cutaneous exposure to allergens. This allergen penetrates that stratum corneum of the skin and is taken up by Langerhans cells. In the sensitization phase, the allergen is captured by antigen-presenting cells and subsequently migrate to the draining lymph nodes. This results in the activation of naive T cells, which differentiates into allergen-specific memory T cells. Upon re-exposure to the allergen, these memory T cells become activated and migrate to the site of exposure, leading to manifestation of ACD. The exact pathogenesis of ACD is unknown though cytotoxic T, T helper (h) 1, Th2, Th17, and Th22 cells have all been implicated in the development of ACD. 

ACD and atopic dermatitis can coexist and certain clinical features can help differentiate ACD from endogenous atopic dermatitis in children. It is important to consider ACD in children with recalcitrant atopic dermatitis or dermatitis with atypical distribution

Patch tests should be supported because confirmatory value of patch tests enables physicians to proceed with confidence

children with atopic dermatitis are more vulnerable to contact sensitization due to loss of normal barrier funtion of skin.