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PubMed2002

Patch testing in discoid eczema.

Fifty patients of both sexes with clinically suspected discoid eczema were patch tested with the Indian Standard Patch Test Battery approved by the Contact and Occupational Dermatosis Forum of India (CODFI). Most of these patients were young adults between 20 and 39 years old, with a mean age of 36 years. The mean duration of symptoms was 21/2 years. The occupational profiles of the patients included farmers (24%), housewives (18%), students (14%), housewives engaged in farming (12%), shopkeepers (10%), and laborers (8%). The miscellaneous group, including technicians, drivers, cable operators, office workers, and computer operators, accounted for the remaining 14%. The common clinical patterns of presentation of discoid eczema included hands and feet (44%), hands and forearms' (30%), legs and feet (12%) and trunk and limbs (12%). Patch test analysis of these patients revealed that, out of the 50 subjects tested, 28 (56%) reacted to one or more allergens. Potassium dichromate was the most common allergen (20%), followed by nickel (16%), cobalt chloride, and fragrance (12% each) in decreasing order of frequency. Hence, it may be concluded that patch testing should be considered for all patients with severe or persistent discoid eczema because allergic contact dermatitis may be relatively common in such patients and the avoidance of offending allergens may be of substantial benefit to the patients.

Adolescent↗
PubMed1988

UV sunlight and patch test reactions in humans.

No seasonal influence of UV sunlight on patch test reactions in humans over a period of 9 years of clinical practice was found in this retrospective study of almost 8000 patients. Although the mean UV monthly dose varies seasonally, up in the summer and down in the winter, no significant differences could be identified for patch test reactions, either for the mean number of positive test reactions or for the intensity of the skin reaction or for the id-like spread reactions seen in summer or winter. Furthermore, no short-term influences of UV exposure during the weekend preceding patch testing could be demonstrated. Therefore, reliable patch-test results can be expected at any season of the year from a general population, at least in Belgian-type climates.

Belgium↗
PubMed1989

Problems raised by the simultaneous reproducibility of positive allergic patch test reactions in man.

The dose of petrolatum patch test material applied with the Leukotest or the Finn Chamber method varies significantly and is one important factor in the lack of reproducibility with present patch test methods. Ready-to-apply methods such as Epiquick and TRUE Test avoid this problem. In a right-side versus left-side comparative study of 19 Epiquick patches on 100 consecutive patients, the reproducibility was 95%. This is a much higher correlation than with previous comparative tests with both identical and different patch test systems.

Allergens↗
PubMed2005

Allergic contact dermatitis from ophthalmic products: can pre-treatment with sodium lauryl sulfate increase patch test sensitivity?

In patients suspected of allergic contact dermatitis because of topical ophthalmic medicaments, patch tests performed with patients' own products are often negative. The irritant anionic surfactant sodium lauryl sulfate (SLS) may alter the stratum corneum and increase antigen penetration. Pre-treatment of the skin with SLS 0.5% for 24 h was performed in the sites of patch tests with patients' own products in 15 selected patients. In patients previously negative to their own products tested with conventional patch tests, SLS pre-treatment showed 6 new relevant positive reactions and induced a stronger positive reaction in 1 patient. SLS pre-treatment could be proposed as an alternative promising method, which may increase sensitivity of patch tests with patients' own products.

Adult↗
PubMed1990

Primin standard patch testing: 5 years experience.

From 1 November 1984 to 1 November 1989. 3075 patients (1949 female and 1126 male) were patch tested with the European standard series, including primin 0.01% pet. 57 positive reactions were obtained (1.8%). About 95% of the patients with positive patch tests were female. 60% of the patch-test-positive patients were above age 60 and 35% above 70 years. The test was negative in all under the age of 20 and rarely positive under the age of 35 years. Only 2 patients had probable patch test sensitization observed 8 and 14 days after application of the test material. 41% of the patients with positive reactions had current primula dermatitis at the time of patch testing. The frequency and high degree of current relevance justify inclusion of primin in the standard series, at least in certain geographical regions. The patch test concentration of 0.01% pet. seems to be correct.

Adult↗
PubMed1998

Reproducibility of the Finn chamber nickel patch test in two different phases of the ovulatory menstrual cycle.

BACKGROUND: Studies on nickel patch test reactivity and reproducibility of positive tests at different points of the menstrual cycle are heterogeneous. OBJECTIVE: To investigate if non-reproducibilities of positive nickel sulphate patch tests in the two different phases of ovulatory menstrual cycles with the endocrine evidence of luteal phase adequacy are statistically different. METHODS: 15 women (group 1) with positive Finn chamber(R) nickel patch test results in the follicular phase of the ovulatory cycle and 13 women (group 2) with positive Finn chamber nickel patch test results in the luteal phase of the ovulatory cycle were tested again in the counter-phases of their ovulatory cycle, with a scheduled interval of 6 weeks following the first tests. Reproducibilities of the tests in the two groups were evaluated statistically. RESULTS: 3 of the positive test results in group 1 (20%) and 2 of the positive test results in group 2 (15.4%) were non-reproducible. The difference was not statistically significant. CONCLUSION: The reproducibility of positive Finn chamber nickel patch tests does not seem to be affected by the changes in the follicular and luteal phases of the ovulatory cycle.

Adult↗
PubMed2002

Comparative frequency of patch test reactions to topical antibiotics.

BACKGROUND: Neomycin, clioquinol and fusidic acid are all topical antibiotics widely used in dermatological practice in the U.K., either as a single agent or in combination with topical corticosteroids. However, an adverse effect of topical antibiotics is contact sensitization. OBJECTIVES: To examine the frequency of positive patch test reactions to fusidic acid, clioquinol and neomycin. METHODS: To compare the frequency of allergic patch test reactions over 1 year, we patch tested all patients attending the St John's Institute of Dermatology contact dermatitis clinic for one calendar year with fusidic acid, neomycin and clioquinol. RESULTS: We patch tested 1119 patients. Positive patch test reactions to neomycin were noted in 40 patients (3.6%), compared with eight patients (0.7%) to clioquinol and three patients (0.3%) to fusidic acid. The frequency of medicament allergy to neomycin was thus five times more common than to clioquinol and ten times more common than to fusidic acid. Although fusidic acid is not part of our extended standard series, it is in our medicaments series. Therefore, in the second part of our study, we reviewed all cases of positive patch test reactions to fusidic acid over the last 20 years. We found that the frequency of hypersensitivity has decreased since the early 1980s despite increasing usage; the current average frequency being 1.62 patch-tested patients per year (1.45%) of those patch tested to the medicaments series). The most common diagnosis in such patients was stasis dermatitis (54.2%). CONCLUSIONS: The frequency of fusidic acid allergy in an eczema population is low and is comparable with published data from over 10 years ago.

Administration, Topical↗
PubMed2005

The role of atopy patch tests in the diagnosis of allergy in atopic dermatitis.

PURPOSE OF REVIEW: Recent literature on the atopy patch test, published since 2004, is reviewed to evaluate whether the pathomechanism of the test has become more evident and whether previous studies require standardization. RECENT FINDINGS: There is evidence accumulating that a smaller subset of patients with atopic dermatitis show only atopy patch test positivity while specific IgE to the same allergen remains negative. It is possible that local IgE-mediated reactions occur in the skin. New data bring us a step forward in understanding the role of the atopy patch test in diagnosis of allergy in atopic dermatitis but no comprehensive studies were published during the period reviewed. SUMMARY: Despite recent advances in determining the value and indication for use of the atopy patch test in atopic dermatitis, more objective studies are needed. The atopy patch test may be useful in understanding the mechanisms of atopic allergy, and in defining the clinical relevance of the airborne allergens in eliciting dermatitis. Regarding food allergy, the atopy patch test still requires standardization. To date, methodology differs in all published papers; even the gold standard, the challenge test itself, is not appropriately standardized, which makes the interpretation of results less reliable.

Bronchial Provocation Tests↗
PubMed1978

Lymphocyte transformation induced by nickel sulphate: an in vitro study of subjects with and without a positive nickel patch test.

Lymphocytes from 8 patients with contact dermatitis and a positive nickel patch test, 7 patients with contact dermatitis due to other factors and with a negative nickel patch test, and 9 other subjects, 7 of whom suffered from other dermatological disorders, were tested with the lymphocyte transformation test (LTT), using nickel sulphate in various concentrations. All execpt one of the nickel allergics showed a significant response to nickel, whereas the controls showed borderline (3 patients) or no response (12 patients). These observations confirm previous findings indicating that nickel hypersensitivity can be diagnosed in vitro. This may be of importance in cases of acute contact dermatitis where patch testing is undesirable. Some individuals with a negative nickel patch test responded significantly though weakly to nickel in the LTT, indicating that apart from acting as a specific antigen (hapten?) nickel sulphate may also have weak non-specific mitogenic properties.

Allergens↗
PubMed2005

Result of standard patch test in patients suspected of having allergic contact dermatitis.

Contact dermatitis is a common skin disease. Disease was diagnosed by a history of contact substance together with geographic distribution of lesion. Up till now, standard patch test is one of the most reliable test to identify and confirm causative agent of allergic contact dermatitis. To determine the rate of positive standard patch test and to identify the common allergen of contact dermatitis in Thailand, we performed the standard patch test in 129 patients, suspected having allergic contact dermatitis at Department of Dermatology, King Chulalongkorn Memorial Hospital, Thailand from June 1, 2003 to September 1, 2004. The rate of positive standard patch test is 59.7% (n = 77/129). The most 3 common positive allergens were nickel sulfate (18.60%), cobalt chloride (17.05%) and fragrance mix (14.73%), respectively. The chance of positive standard patch test significantly correlated with sex (woman), initial diagnosis as contact dermatitis and history of house-worker (p = 0.017, p = 0.005 and p = 0.023, respectively). Whereas, there were no significant correlation between the chance of positive standard patch test and age of patient, location of lesion, history of recurrence, history of atopy, history of drug and food allergy. In addition, history of metal allergy significantly correlated with the chance of positive nickel sulfate or cobalt chloride in standard patch test (p = 0.017). In conclusion, this study demonstrated the prevalence of causative allergen of contact dermatitis in Thai patients using that standard patch test. Moreover, our data shown that the chance positive standard patch test was greater in patient, who were women or initial diagnosed as contact dermatitis or had history of houseworker or history of metal allergy.

Adolescent↗
PubMed1999

Patch testing with natural rubber latex.

Immediate-type hypersensitivity to natural rubber latex (NRL) may be associated with chronic eczema, and it has recently been suggested that NRL should be used as a patch-test allergen. However, a standardized preparation does not exist, and experience of patch testing with this substance is extremely limited. The aims of our study were to investigate the patch-test response to different preparations of NRL amongst patients with suspected contact dermatitis. 608 patients were patch tested with a latex series which included wet and dry preparations of undiluted high-ammonia (HA) NRL and low-ammonia thiuram-containing NRL. Cutaneous reactions to 1 or more NRL patches were noted in 24 patients. None of these were strong allergic reactions (> +), and in 15 patients, the responses were only doubtful (?+). Positive patch tests were observed in 9 patients, and were probably due to concurrent thiuram allergy in 6. In the remaining 3 patients, the reactions had subsided by the 2nd reading and may have represented false positives. None of the patients showed consistent allergic reactions to all NRL patches, and most of the doubtful readings had resolved within 4 days, suggesting that they were irritant rather than weak allergic responses. Patch testing to dry HA latex was associated with the least number of reactions. We conclude that allergic patch test reactions to NRL are uncommon, and as reactions are usually weak and difficult to interpret, we suggest that patch testing with NRL should remain experimental until further studies have been undertaken.

Adolescent↗
PubMed1997

Estimating dilutions for patch testing skin care products: a practical method.

When patch testing, it is helpful to patch test with the patient's own topical products. However, the thickness (viscosity) of the product often prevents easy measurement for dilution. A method of estimating volume: volume dilutions that requires minimal investment in supplies is presented. This method is only applicable to personal products and is not suitable for industrial or household chemicals.

Allergens↗
PubMed1996

Patch testing with a combination of unrelated allergens: a new strategy.

A simplified method of patch testing was designed, in which several totally unrelated allergens were combined in each patch. The method was evaluated by double blind comparison of responses to 17 standard allergens applied individually as 17 conventional patch tests, and as two different sets of five patches each containing combinations of three of four allergens per patch, in 137 patients under investigation for contact allergic dermatitis. There were 89 positive responses to conventional patch testing with separate allergens and 94 and 86 positives to the two different combinations of the same allergens. Concordance of positive reactions to the two combinations was 80% and there were no irritant reactions. Conventional testing detected 70 and 74% of reactions to combination patches 1 and 2 and combination patches 1 and 2 detected 80 and 79% of the reactions to conventional testing. The combinations detected clinically relevant sensitivities not found by conventional testing. Thus, combination patch testing appears to give consistent and reliable results; its use would reduce the number of patches and increase the diagnostic yield for the specialist and permit preliminary screening by the general practitioner.

Adult↗
PubMed2003

[Patch tests in the diagnosis of food allergies in the nursing infant].

The atopy patch-test has been shown to be useful in diagnosis of delayed reactions in infants with atopic dermatitis or digestive symptoms. The combination of skin prick testing and patch testing can significantly enhance the accuracy in diagnosis of specific food allergy in infants with atopic dermatitis or digestive symptoms.

Dermatitis, Atopic↗
PubMed1991

The nickel content of certain commercially available metallic patch test materials and its relevance in nickel-sensitive subjects.

The nickel contamination of the metallic patch test substances from 3 commercial sources was estimated by atomic absorption spectrophotometry. Contamination was generally greatest in the cobalt patch test substances. To determine whether the levels of contamination encountered were sufficient to produce a false positive patch test, 20 nickel-sensitive patients were patch tested to various concentrations of free elemental nickel in aqueous solution. The level of nickel contamination was less than that required to produce a false positive patch test in our patients, but was at a level which could produce false positive reactions in subjects highly sensitive to nickel.

Adolescent↗
PubMed2002

[Relationship between ethanol patch test and problem drinkers among dental students].

In 2000 and 2001, we carried out a drinking habit survey and the Ethanol Patch Test on 232 fourth-year dental students (128 males, 104 females). The results were statistically analyzed. For the survey, the students were asked to fill out, anonymously, the forms of the Tokyo-University ALDH2-Phenotype Screening Test (TAST), the Kurihama Alcoholism Screening Test (KAST), and the Adolescent Alcohol Involvement Scale (AAIS). The results of the subsequent Ethanol Patch test were evaluated by the students themselves. The Patch test demonstrated that 44.5% of males and 49.0% of females were positive to the test or ALDH2 deficient, the rest having the marker substance. According to the TAST results, ALDH2-deficient or TAST-positive (alcohol-intolerant) subjects accounted for 48.4% of males and 51.9% of females, the rest being ALDH2-present or TAST-negative students. Among the Patch test-positive group, the ratio of problem drinkers according to the KAST was 8.8% in males and 2.0% in females. The corresponding figures for the test-negatives group were; 22.5% in males; 7.5% in females, being higher than those for the test-positive group. Among the test-positive group, the ratio of problem drinkers scoring at least 42 points on the AAIS stood at 19.3% in males, 7.8% in females and among the test-negative group, the corresponding figures were; 21.1% in males; 13.2% in females, the difference from those for the other group being relatively small. The results of the Ethanol Patch test were related to those of the TAST and KAST, but not to the AAIS. The correlation between the Patch test and KAST indicates that the test-negatives are prone to become alcohol-dependant. Though the results of the Patch test and those of the AAIS were not related, the findings show that some alcohol-intolerant university students are drinking excessively.

Adult↗
PubMed1995

Is the European standard series suitable for patch testing in Riyadh, Saudi Arabia?

Due to the lack of a regional patch test series in our geographical area, the suitability of the European standard series was evaluated by patch testing dermatitis patients in Riyadh, Saudi Arabia. Of 240 consecutive patients with various forms of dermatitis, 136 (57%) showed 1 or more positive patch tests, women, 74 (54%), slightly outnumbering men, 62 (46%). Positive reactions were found to 21 of the 22 items in the test series. Sensitization was most common to nickel sulfate (51 = 37.5%), potassium dichromate (48 = 35%) and cobalt chloride (43 = 32%) The frequency of sensitization to nickel was higher in women (41 = 30%) while that to dichromate was higher in men (39 = 29%). Less reactions were found to fragrance mix (21 = 15%), formaldehyde (15 = 11%) and neomycin sulfate (15 = 11%). Sensitization to other allergens ranged between 10 and 1%. Less than 1% of patients (0.7%) reacted to benzocaine and none to primin. The frequency of occurrence of multiple sensitivities is also presented. We conclude that the European standard series is suitable for patch testing dermatitis patients in our region, with the exception of benzocaine and primin. The addition of 3 allergens that could be of local relevance is discussed.

Adolescent↗
PubMed2000

Symptoms and signs reported during patch testing.

BACKGROUND: In a pilot questionnaire study, there was a high frequency of subjective complaints and distant skin reactions during patch testing as reported at the day of test reading, particularly in female patients. OBJECTIVE: To document in a controlled study possible side-effects of a generalized nature occurring during the test procedure. METHODS: A questionnaire study on symptoms and signs reported at application and at reading of standard patch tests was conducted with 401 patients, with the patients serving as their own controls. RESULTS: An eczematous flare-up during patch testing was observed in 3.7% of the patients. There were plenty of different symptoms of malaise but, with one exception (itch on the back), the number of symptoms tended to be less on the day of reading than on the day of application of the tests. This held true also for itch occurring in the patients' dermatitis. There was no statistical correlation between symptoms and signs on the one hand and positive patch tests on the other. CONCLUSION: Distant skin reactions and impairment of general health occurring during patch testing are often reported at the time of test reading. However, with the exception of itch on the back, symptoms and signs are rather less common after the application of patch tests than before.

Adult↗