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At least 217 records · Page 12Linked to original sources
PubMed2000

Survey of patch testing in Scotland.

We have surveyed Scottish dermatologists to establish the extent of patch testing, to assess the reasons for referral and to document resources and methods used by dermatologists. 104 questionnaires were sent to members of the Scottish Dermatological Society. 82 questionnaires (79%) were returned. 50% of respondents were consultants, 27% were trainees and 23% held staff grade or clinical assistant positions. The mean waiting time for a patch test appointment was 4.5 months. The most frequent reasons for patch testing were localized eczema, eczema not responding to conventional treatment, occupational eczema, history of contact sensitivity and eczema of uncertain cause. 17 of 82 respondents (21%) were the principal clinicians supervising patch testing in their hospitals. 11 of 17 read reactions at 2 and 4 days. Mean time spent on advising patients was 13 min per patients. 7 of 17 were dissatisfied with resources available for patient education and 16 of 17 felt they would benefit from a central source for patient information. Only 4 of 17 centres recorded patch test results on a database and 3 centres regularly reviewed their patch test results. In conclusion, we have identified areas of patch testing that require further improvement.

Dermatitis, Allergic Contact↗
PubMed1980

[Allergy to rosin caused by patch tests].

5 commercial patch-test-products were investigated by gas chromatography. Colophony was detected in three of the products, and the allergen was found in the adhesive component.

Adhesives↗
PubMed1999

The reproducibility of patch tests.

There is conflicting evidence regarding the reproducibility of patch testing. Discordant results have been reported in up to 44% of cases. The clinical relevance of these discordant patch tests has not been previously assessed. We studied 383 consecutive patients receiving simultaneous duplicate patch testing on opposite sides of the upper back with 10 allergens from the European standard series. Completely discordant patch tests-a negative test on one side with a positive test on the opposite side-were recorded in 30 (8%) patients. Two patients had discordant tests to two of the allergens; 28 had discordant reactions to one allergen. Completely discordant tests were recorded for nickel in 10 (3%) patients, balsam of Peru in two (0.5%), thiomersal in one (0.3%), cobalt in four (1%), paraphenylenediamine in three (0.8%), fragrance mix in two (0.5%), formaldehyde in four (1%), potassium dichromate in two (0.5%), lanolin in three (0.8%) and Kathon CG in one (0.3%). Of those patients with completely discordant patch tests, the allergen was deemed to be a true positive in 11 (3% of total) cases and of possible relevance in a further three. The allergen was felt to be relevant to the presenting complaint in seven (2% of total) patients.

Adolescent↗
PubMed2001

Patch testing by additional series of allergens: results of further experiences.

BACKGROUND: Patch testing with additional series (AS) of allergens may be a useful tool in diagnosing allergic contact dermatitis (ACD). OBJECTIVE: Aim of the study was to verify the usefulness, to check the reliability in clinical practice and to evaluate the economic costs of AS previously built up. METHODS: A total of 281 patients with suspicious ACD underwent patch test with the standard series (SS) and with one or more AS (51 among 71 built up). RESULTS: A total of 170 patients (60.5%) showed positive reactions to SS; 116 (41.3%) to AS. Among 582 nonstandard allergens used, 113 (19.4%) elicited 1 or more positive reactions: out of 10,916 patch tests carried out, 260 (2.4%) positive reactions were observed. The correlation between SS and AS indicated that 8.2% patients resulted SS-/AS+, 27.7% SS+/AS-, 32.7% SS+/AS+, 31.3% SS-/AS-. The most frequently used AS showed the following percentages of patients with 1 or more positive reactions: clothes 41.4%, building industry 51.8%, hairdressers 77.3%, textile industry 42.1%, shoes 36.8%. Positive reactions to the most frequently used nonstandard allergens resulted: propylene glycol 0.4%, cobalt chloride 12.6%, phenylmercuric nitrate 2.2%, p-aminophenol 4.5%. The approximate economic cost of patch testing with AS has been evaluated in 1.3 euro per single patch test. CONCLUSION: The cost of patch testing AS is not irrelevant, but it can be compensated by the advantages deriving from the increase of data concerning ACD etiology. A reduction in the number of allergens included in single AS should be performed. Cobalt chloride, taking into account the high percentage of positive reactions observed and its presence in a large number of AS, could be (re)introduced in the standard series.

Adult↗
PubMedDate not supplied

Antigen preparation for the patch test.

At this time patch testing is the most important tool in the evaluation of patients with dermatoses. From 70 to 80% of all cases of contact allergy are estimated to be discovered by using the standard trays with just 20 to 30 different substances and mixes.

Allergens↗
PubMed1997

Patch testing for contact dermatitis.

Patch testing is perhaps not an exact science, but it is the best method available for identifying and confirming contact sensitivity. Illustrated step-by-step instructions for the procedure are presented, with helpful hints to avoid some of the pitfalls.

Dermatitis, Contact↗
PubMed2004

Patch test for the detection of contact allergens.

Patch Test was done in 340 suspected allergic contact dermatitis patients having different ages of both sexes during the period of January 2000 to December 2003 in the department of Dermatology and Venerology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Of these 340 cases 145 (42.65%) were male and 195 (57.35%) were female. Among these 340 cases, 250 (73.53%) cases were tested with international standard series allergen (ISS) and 90 (26.47%) cases with cosmetic series allergen (CSS), of which patch test was positive in 125 (50%) cases and 65 (72.22%) cases respectively. The 125 positive cases with ISS consisted of 56% male and 44% female. In 65 CSS positive cases 90.77% were female and 9.23% were male. Highest incidence of positive patch test was found in 61.54% cases in the age group of 30-39 years in ISS and 71.43% cases in the age group of 20-29 yrs in CSS. In ISS--Potassium Dichromate (19.2%), Fragrance mix (17.6%), Nickel Sulphate (15.2%) and PPD (11.2%) were found to be the common allergen and in CSS--Octyl Gallate (27.69%), Getrimide (18.92%), Balsum of Peru (15.38%), Thiomersal (12.31%) were found to be the common allergens.

Adolescent↗
PubMed2001

Patch test sensitization caused by para-tertiary-butylcatechol. Results of a prospective study with a dilution series.

Para-tertiary-butylcatechol (PTBC) has been patch tested in Europe at 1% in petrolatum (pet.) and is now suspected of induction of patch test sensitization. A prospective study was initiated to obtain detailed data on this undesirable risk. A dilution series of PTBC (1%, 0.5%, 0.25%, 0.1% pet.) was used. Patch tests were read on days (D) 1-3, 7, 14 and 21 after application. Patients who were unable to return for late readings were telephoned and asked to report any reaction at the patch test sites. 40 out of 46 patients included completed the study. Patch tests were negative in 35 patients. 4 patients showed a positive patch test at later readings only (D7-D21); 2 patients reacted to a concentration as low as 0.1%. Rechallenge was performed in 2 of these patients, revealing a clearly positive reaction as early as D2 after patch test application. PTBC clearly induced patch test sensitization in 10% of the patients. It cannot be excluded that patch testing with 0.25% PTBC or with even lower concentrations might induce patch test sensitization. The optimal patch test concentration still has to be determined but may be within the range of 0.01% to 0.25% PTBC.

Adult↗
PubMed2000

Ethanol patch test: a simple method for identifying the effectiveness of cyanamide in alcoholics.

BACKGROUND: To identify the pharmacological effectiveness of cyanamide, 144 alcoholics treated with cyanamide were subjected to a test that used an acetaldehyde dehydrogenase (ALDH) inhibitor, the ethanol patch test, which is considered to be a good indicator of ALDH2 phenotype. METHODS: We placed 100 microl of 70% ethanol on a lint pad and, as a control, placed the same volume of distilled water on a second pad. The ethanol patch test was performed on 144 alcoholics more than 2 weeks after abstinence from alcohol before and after treatment with cyanamide for 1 week. The dose of cyanamide was increased up to 150 mg until the patch test yielded a positive result. RESULTS: In the ethanol patch test, 36 alcoholics (25.0%) gave a positive result before treatment with cyanamide and might have been ALDH2(1)/2(2) heterozygotes. Among 108 alcoholics who were not positive, the distribution of the cyanamide dose that yielded a positive ethanol patch test result was 30 mg in 42 cases (38.9%), 50 mg in 33 cases (30.6%), 70 mg in 5 cases (4.6%), 100 mg in 6 cases (5.6%), and 150 mg in 2 cases (1.9%). Prevalence of liver cirrhosis was significantly higher in alcoholics who showed a positive ethanol patch test result at doses of less than 50 mg cyanamide than those at doses more than 70 mg (p = 0.029). The prevalence of adverse effects was significantly higher in alcoholics who showed a positive ethanol patch test result at doses of more than 70 mg than at doses of less than 50 mg cyanamide (p = 0.002). CONCLUSIONS: The ethanol patch test is a useful method for identifying pharmacological effectiveness of cyanamide and may reduce the prevalence of side effects in cyanamide-treated alcoholics.

Adult↗
PubMed1980

Nonanoic acid irritation - a positive control at routine patch testing?

A false negative patch test can be related to errors in the testing procedure, or to a defect in the eliciting (efferent) phase of the immune response. To define this phase the application of a topical irritant (a "positive control") is suggested. Various concentrations of nonanoic acid in 1-propanol were applied to 116 healthy volunteers and to 75 dermatitis patients. Dose-response curves were obtained (concentrations 5, 10, 20 and 39.9%). Twenty percent nonanoic acid produced skin reactions in 90.1--93.9% of the subjects. The lesions consisted mainly of erythema at 48 h and pigmentation at 96 h. We suggested that the most interesting patients are those negative to this primary irritant and thay they should be further evaluated.

Adult↗
PubMed1992

Erythema multiforme reaction to patch testing.

A young woman developed erythema multiforme in association with multiple patch test reactions. Sequential patch testing revealed 2 true positive reactions (colophony and fragrance mix), and was not associated with flare of erythema-multiforme-type lesions. The development of erythema multiforme should be included in the list of possible adverse reactions to patch testing, albeit a rare occurrence.

Adult↗
PubMed2003

Relevance of positive patch test reactions in patients attending a dermatology tertiary referral centre.

Our purpose was to determine the proportion of relevant patch test reactions among all patch tested patients in the National Skin Centre (NSC), Singapore, from 1 January 1999 to 31 December 2000. A retrospective study was made of the patch test records of all patients patch tested in the study period. The proportion of relevant patch tests in this population was then determined. The allergens most likely to have present or past relevance were: nickel sulfate (79%), p-phenylenediamine (76%), colophonium (73%), cobalt chloride (68%) and potassium dichromate (67%). The most common allergens for each of the following relevance categories were as follows - present: p-phenylenediamine, thiuram mix, potassium dichromate; past: colophony, nickel sulfate, cobalt chloride; exposed: neomycin, gold sodium thiosulfate, fragrance mix and unknown: gold sodium thiosulfate, potassium dichromate, cobalt chloride. Evaluating relevance is difficult, and the results of relevance scoring vary widely between different groups. A consensus on the definition and standardization of the concept of relevance is needed.

Allergens↗
PubMed1981

Nickel allergy--reliability of patch test. Evaluated in female twins.

The recommended patch test procedure for nickel allergy with 5% NiSO4 in petrolatum was evaluated in a total of 169 female twins selected on the basis of a positive history of metal sensitivity. At the time of the evaluation most of them were healthy without current dermatitis. Of 88 female twins with a history of nickel sensitivity 62 (72%) had positive reactions after patch tests with 5% NiSO4 in petrolatum. In the remaining 26 the loss of epicutaneous reactivity was independent of age and time lapsed since the last episode of clinical dermatitis, and it did not occur more often in monozygotic than in dizygotic pairs. The number of negative reactions was greater after an exposure time of only 24 h than after 48 h. In 103 consecutive patients 2.5% NiSO4 in 50% DMSO or 5% NiCl in petrolatum were evaluated as possible alternative test substances. These tests produced a large number of irritant reactions and are therefore not suitable for routine use. One patient with a positive history of nickel allergy reacted negatively with 5% NiSO4 in petrolatum but had a true positive reaction with 5% NiCl. Obviously, 5% NiSO4 may give false negative reactions, and alternative test substances can therefore be useful in selected cases. In the present twin material positive nickel patch tests did not produce "angry back" reactions.

Aged↗
PubMed1993

Patch testing in cutaneous reactions caused by carbamazepine.

The usefulness of patch testing in the diagnosis of carbamazepine-induced allergic skin eruptions was studied in 18 patients with previous histories of skin eruptions caused by carbamazepine. The etiological role of carbamazepine was ascertained by peroral or topical provocation in 15 (out of 18) patients. The clinical reactions caused by the drug were classified as maculopapular exanthema with general symptoms (7 patients), other type of exanthema (3), exfoliative dermatitis (erythroderma) (3), fixed drug eruption (3), erythema multiforme (1) and urticaria (1). Patch testing showed positive reactions to carbamazepine in 7 patients; in addition, 2 patients had doubtful reactions. Positive patch test reactions were seen only in patients with exfoliative dermatitis (all 3 patients) and maculopapular exanthema (4 out of 7). None of the patients with fixed drug eruption, erythema multiforme or urticaria, or the control subjects, had positive patch test reactions to carbamazepine. The present study suggests that patch testing is useful in the diagnosis of carbamazepine allergy in patients with maculopapular eruptions or erythrodermas.

Adolescent↗
PubMed2004

Sensitization to petrolatum: an unusual cause of false-positive drug patch-tests.

We report on an unexpected sensitization to petrolatum diagnosed with the occurrence of multiple nonrelevant and false-positive drug patch-tests performed while investigating a patient suffering from many cutaneous adverse drug reactions. All the positive drug patch-tests were prepared with GILBERT vaseline. This petrolatum reaction is positive as it was tested with five other brands of petrolatums a few months later. As the same petrolatums, but from different batches were tested, patch-tests with GILBERT petrolatum were doubtful, while other petrolatums were positive. White petrolatum is a mixture of semisolid hydrocarbons of the methane series. The sensitizing impurities of petrolatum are polycyclic aromatic hydrocarbons, e.g. phenanthrene derivatives. The purity of petrolatum depends on both the petroleum stock and on the production and packaging methods. Even if rare, contact sensitization to petrolatum can disturb the interpretation of drug patch-tests. It is necessary in the interpretation of drug patch-tests to test both in petrolatum and other vehicles and with all the different petrolatums used in preparing the material for drug patch-tests. So, it is essential to advise the patients sensitized to petrolatum to remove all the topical drugs, such as all the cosmetics, which contain petrolatum in their formulation.

Dermatitis, Contact↗
PubMed1996

Allergic contact dermatitis from doxepin cream. One-year patch test clinic experience.

BACKGROUND AND DESIGN: Several topical antihistamines are known to cause contact allergy. Premarket predictive patch testing with doxepin cream showed it to have "low risk of irritation and sensitization" on normal human skin. In our patch test clinic, we routinely test topical preparations, and over a recent 1-year period, we patch-tested doxepin cream, the standard screening tray, and other topical preparations on 97 patients with various pruritic dermatoses. When possible, patients with positive reactions to doxepin cream were patch-tested with its ingredients, and repeated open-application use tests were also performed with the product. RESULTS: Seventeen patients had relevant positive patch test reactions to doxepin cream and 80 had negative reactions. In 13 of the 17 patients with positive reactions, the diagnosis of allergic contact dermatitis to doxepin cream was confirmed by positive patch test reactions to both the active ingredient and the whole formulation of doxepin cream, by an observed positive use test reaction to doxepin cream, or by both. Of 14 patients who completed testing with doxepin cream ingredients, all had positive reactions to the whole formulation, and 12 had positive reactions to doxepin hydrochloride. Repeated open-application use tests with doxepin cream on normal skin resulted in positive eczematous responses in eight of 10 patients. Eight of the 17 patients had concurrent, relevant positive reactions to other patch tests, especially to fabric-finish resins and to ingredients of other topical preparations. Many had long-standing dermatitis, and each had used doxepin cream for several days to 1 year. Two patients appeared to have had systemic contact dermatitis. CONCLUSIONS: Diagnostic patch test clinic experience illustrates that doxepin cream is a contact sensitizer on inflamed skin. Oral doxepin should be avoided in patients with doxepin contact allergy.

Administration, Cutaneous↗
PubMed1996

Patch testing in severe cutaneous adverse drug reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.

Patch testing may help to assess the culpability of a drug in an adverse reaction. Our aim was to study patch testing in severe cutaneous adverse drug reactions (ADRs) (Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP), and other cutaneous ADRs). 59 patients with cutaneous ADRs were included: 22 had SJS/TEN, 14 AGEP, and 23 other cutaneous ADRs. Patients were patch tested with the suspect drug, and with a standard series of drugs. 2 patients among the 22 SJS/TEN cases had a relevant positive test. 7 patients among the 14 AGEP cases had a relevant positive test. 6 patients among the 23 other cutaneous ADRs had a relevant positive test. Our results suggest that patch testing has a weak sensitivity in SJS/TEN and is not appropriate in these diseases. Patch testing seems more adapted to other cutaneous ADRs, such as AGEP, in which the proportion of positive patch tests was significantly higher (p < 0.02). Nevertheless, the difference of sensitivity of patch testing in SJS/ TEN, AGEP or other cutaneous ADRs could be linked not only to the clinical type of eruption, but also to the different spectrum of culprit drugs in each type of eruption.

Adult↗