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At least 37 records · Page 2Linked to original sources
PubMed2003

The association between ambient air conditions (temperature and absolute humidity), irritant sodium lauryl sulfate patch test reactions and patch test reactivity to standard allergens.

To support the decision as to whether erythematous patch test reactions to allergens are irritant or allergic, sodium lauryl sulfate (SLS, 0.5% in water) has been added to the standard patch tests since July 1996 in the Dortmund Department of Dermatology. Data on 1600 patients patch tested up until June 2001, as well as standardized data on ambient temperature and humidity obtained by the German Meteorological Service, were included in a logistic regression analysis taking age, sex and atopy as potential confounders into account. The pattern of association was heterogeneous: while doubtful reactions to nickel sulfate were significantly associated with dry/cold weather conditions, but not with SLS reactivity, the opposite was observed for lanolin alcohol, benzocaine and Myroxylon pereirae resin (balsam of Peru). Doubtful reactions to other allergens, namely formaldehyde, fragrance mix or p-phenylenediamine, were associated with both factors. For several other allergens of the standard series, no distinct, significant pattern could be discerned. In conclusion, meteorological conditions and SLS reactivity independently contribute information on individual irritability at the time of patch testing, and both should be considered.

Allergens↗
PubMed2002

Drug eruptions: the value of oral rechallenge test and patch test.

All in-and out-patients, who came for drug eruption consultation at the Dermatology Clinic, Ramathibodi Hospital from December 1997 to November 1998 were included in this study. Medical histories and physical examinations were performed by one of the authors. In suspected cases, a skin biopsy was performed to confirm the diagnosis. Patch test and oral challenge test were performed in some patients who had maculopapular, fixed drug eruption and acute generalized exanthematous pustulosis, with informed consent. Among 80 patients, the most common cutaneous reaction was maculopapular rash. Antimicrobial, drugs were the most common causative agents. The patch test was positive in only one patient from 12 cases. The oral provocative test was positive in two patients from 4 cases. It is concluded that oral provocative test is still necessary to get a definite diagnosis of causative agent. The value of patch test needs further study.

Administration, Oral↗
PubMed1998

Prognostic patch testing: the other kind of patch test.

Prognostic patch testing differs from diagnostic patch testing. Clinicians routinely perform diagnostic patch testing, but prognotic patch testing is the province of corporate research and development departments and, in the United States, contract laboratories. The three types of prognostic patch testing are described and referenced in the scientific and medical literature. A comparison among the three types of prognostic patch testing and diagnostic patch testing is provided. In addition, the variables in both prognostic and diagnostic patch testing are listed, as well as the types of ingredients and products routinely tested in prognostic patch testing.

Consumer Product Safety↗
PubMed1977

Lymphocyte-stimulation tests and patch tests to carbamazepine hypersensitivity.

Seven cases of severe hypersensitivity to carbamazepine (Tegretol) were described in patients with epilepsy or trigeminal neuralgia. Clinical manifestations consisted of fever, rash, facial oedema, lymphadenopathy, impaired liver function, eosinophilia and atypical lymphocytes in the peripheral blood. Lymphocyte-stimulation tests with carbamazepine in vitro showed positive results in all cases; patch tests with carbamazepine were positive in six cases. In two cases the lymphocyte-stimulation tests with carbamazepine were found to be negative during, and shortly after, the illness. However, when the tests were repeated several months later, they turned out to be positive. Lymphocyte reactivity to PPD and PHA in vitro was also impaired during the acute phase of the disease. Thus false-negative lymphocyte-stimulation tests may be found in the first months following such a hypersensitivity reaction, probably due to impaired lymphocyte reactivity. As carbamazepine is a potent drug and is often prescribed for long periods together with other anticonvulsants, it seems important to prove that the allergic reaction is caused by carbamazepine. If the lymphocyte-stimulation test in vitro or the patch test with carbamazepine is found to be negative during or shortly after the illness, they should be repeated several months later.

Carbamazepine↗
PubMed2006

The role of intradermal skin testing and patch testing in the diagnosis of autoimmune progesterone dermatitis.

Autoimmune progesterone dermatitis is a rare clinical condition in which patients display hypersensitivity to endogenous progesterone. It manifests as a cyclical cutaneous eruption that flares during the luteal phase of the menstrual cycle, when progesterone levels peak, and resolves partially or completely a few days after menses. Its cutaneous manifestations are variable and include urticaria, eczematous eruptions, vesiculopustular eruptions, fixed drug eruptions, stomatitis, erythema multiforme, and anaphylaxis. Autoimmune progesterone dermatitis has been diagnosed previously with intradermal skin testing or intramuscular progesterone challenge. Treatment of progesterone hypersensitivity generally consists of ovulation inhibition with pharmaceutical agents or oophorectomy; other therapies (eg, thalidomide) have also been used with success. We report a case of cyclical erythema multiforme (EM) induced by hypersensitivity to endogenous progesterone in a patient with a history of past oral contraceptive use. After herpes simplex virus was ruled out as an etiologic factor, a diagnosis of progesterone hypersensitivity was confirmed with intradermal skin testing. Results of subsequent patch testing with various progesterone derivatives were negative. The EM outbreaks were suppressed temporarily by continuous administration of Loestrin (ethinyl estradiol plus norethindrone), which also increased the responsiveness of the outbreaks to prednisone tapers.

Adult↗
PubMed1975

Chamber test versus patch test for epicutaneous testing.

A new modification of the chamber test for epicutaneous testing, and improved auxiliary equipment are presented. Compared with the customary patch test, the chamber test in its present form has several remarkable advantages, which are described in detail.

Dermatitis, Contact↗
PubMed2006

A high-positive patch test load correlates with further positive patch test reactions irrespective of their location.

BACKGROUND: Patch testing is the standard clinical procedure to prove contact sensitization. It is a common practice to attach multiple patch tests at the same time. However, synchronous reactions to unrelated allergens may not be completely unassociated. If so, the reaction in a given test field might be influenced by other positive test reactions in a distance-related degree. This article analyses whether there is a distance-related effect of synchronous positive patch test reactions on the outcome of a target patch test. METHODS: Data collected from patients patch tested for diagnostic purposes with 15 standard allergens attached in a specific pattern between 1992 and 2004 in 20 centres in a Central European network were retrospectively evaluated. The association between the target patch test result (allergic vs negative reaction to the thiuram mix) and the number and cumulated strength of synchronous positive reactions (positive patch test load) to allergens placed in nearby or distant positions to the target patch was analysed by using logistic regression analysis. RESULTS: The likelihood of a positive reaction to thiuram mix significantly increased with an increasing synchronous positive patch test load generated by positive reactions to allergens unrelated to thiuram mix. The effect of allergens neighbouring the target allergen was not significantly stronger than that of allergens placed in distant positions. CONCLUSION: For the interpretation of patch test results, the potentially enhancing effects of a synchronous positive patch test load should be considered. The local distribution of the patches on the back is, however, not critical.

Dermatitis, Contact↗
PubMed1977

Experimental investigations in guinea pigs on the recognition of the allergic eczematous reaction: A comparison of the macrophage migration inhibition test with the patch test.

1. The patch test as an in vivo test has disadvantages. It is our impression that biologically false reactions occur in approximately 5%. 2. The MIT as an in vitro test is very time consuming, but safe for the patient. It is supposed to give up to 20% false reactions. 3. In 76 and 72% of 156 guinea pigs sensitized with potassium bichromate and sulfasol respectively, both the test methods gave results in agreement. 4. Sensitization by potassium bichromate estimated by patch test only was 30%, and by MIT only also 30%, but the two test methods disagreed in 24%. 5. Sensitization by sulfasol evaluated in the patch test only was 36%, and in the MIT only 48% but the two test methods disagreed in 28%. 6. The differences between the results of the two test methods are not satistically significant and their failure rate does not provide absolutely sure results, but we believe that the patch test is preferrable in recognition of contact allergy because it is in vivo and probably has a lower failure rate in comparison with the MIT in the human.

Animals↗
PubMed1995

The influence of patch tests with clobetasol propionate on adjacent patch test reactions.

Contact allergy to corticosteroids now seems frequent among patients being patch tested. As corticosteroids are intrinsically anti-inflammatory, we investigated whether patch tests with a potent corticosteroid might suppress simultaneous adjacent patch test reactions to another allergen. Nickel-sensitive subjects were patch tested with an aqueous dilution series of nickel in duplicate, adjacent to patch tests with clobetasol propionate 1% in ethanol and with ethanol, respectively. Statistical evaluation of the results obtained in 2 different centers, using their own patch test techniques, did not reveal any suppression of the positive nickel patch test reactions.

Clobetasol↗
PubMed1999

The association between size of test chamber and patch test reaction: a statistical reanalysis.

A recent study by Brasch and co-workers reported on the association between size of test chamber and patch test reaction. The investigators interpreted their data on 495 patients as having conclusively shown that standard preparations of fragrance mix, wool wax alcohols, Kathon CG and formaldehyde led to more positive test reactions when large Finn Chambers were used for patch testing. We have scrutinized the statistical aspects of this study and conclude that the authors should have adopted a statistical approach suitable to analyse dependent samples. After explaining the correct methodological way of dealing with quadratic contingency tables formed by 2 dependent samples, we reanalyze the data accordingly and compare the results to those of the original paper. Based on this reanalysis, the conclusions are more complex: the reaction pattern for the fragrance mix and wool wax alcohols is significantly different between small and large test chambers; however, this discrepancy arises primarily from changing weak positive reactions with small chambers to strong positive reactions with large chambers. For formaldehyde, no relationship between chamber size and patch test reaction was found in the data, while for Kathon CG, statistical evidence is borderline that more positive test reactions are yielded by large test chambers than by small ones.

Adult↗
PubMedDate not supplied

Epicutaneous patch testing.

Epicutaneous patch testing is still regarded as the best method of diagnosing allergic contact dermatitis. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. During the last decades of the 20th century a lot of effort was put into standardization of materials and methods used in patch testing. Patch tests can be used to confirm a suspected allergic contact dermatitis and either to recommend avoidance of particular products or to recommend alternative products in a particular patient. The true rate of clinically relevant hypersensitivity in positive patch test reactions remains to a great extent unknown. The ideal patch test should cause as few adverse reactions as possible, but a lot of adverse reactions have been described. How-ever, it has to be noted that the overall risk-benefit equation of patch testing is in favor of the benefit, if performed correctly and with the proper indications. A careful history taking and attention to the clinical picture are key actions to facilitate the interpretation of the clinical relevance of the epicutaneous patch test results.

Allergens↗
PubMed2002

American College of Allergy, Asthma & Immunology Patch Testing and Allergic Dermatologic Disease Survey: use of patch testing and effect of education on confidence, attitude, and usage.

BACKGROUND: The patch test is an important tool for the diagnosis of contact dermatitis. In the past few years, allergists have shown increased interest in the diagnosis of contact dermatitis and the use of patch testing. OBJECTIVE: The aim of this study was to determine (1) the frequency of usage of the patch test among allergists, (2) the factors that affect the decision to patch test, and (3) the need for training the allergist to perform patch testing. METHOD: A single mailing survey was sent to all the members of the American College of Allergy, Asthma and Immunology (ACAAI). RESULTS: Fifty-seven percent of responding allergists performed patch testing but did so infrequently. Those who were fellowship trained in patch testing or attended a sponsored workshop performed the test more frequently than those with no training. Those who perceived the patch test as useful also were more likely to perform the test. Fellowship-trained members felt more confident than workshop-trained members in performing the test, and both, in turn, were more confident than members with no training. Trained physicians also were more likely to find the test useful compared with those with no training in patch testing. CONCLUSIONS: Education through fellowship training and workshop was associated with greater self-confidence of the allergist in his/her ability to perform patch testing. Education also was associated with increased perception of patch test utility and increased usage of the test.

Adult↗
PubMed2001

Combination therapy improves the recovery of the skin barrier function: an experimental model using a contact allergy patch test combined with TEWL measurements.

BACKGROUND: Nickel (Ni) allergic contact dermatitis (ACD) alters the skin barrier. OBJECTIVE: Our aim was to compare the efficacy of combination therapies on ACD, using a topical corticosteroid and a corneotherapy agent (barrier cream), with that of a single therapy with corticosteroids. METHODS: On day 1, 3 Ni test patches were applied on each forearm of 14 Ni-patch-test-positive females. Four contained 5% Ni and 2 physiological saline. Either topical corticosteroid or barrier cream were matched with the combination of both products on 3 of the 4 Ni ACD. The fourth was not treated. Clinical scoring, transepidermal water loss (TEWL) and stratum corneum (SC) capacitance were measured before (day 1) and after (days 4-8) ACD. RESULTS: The combination therapy showed a significant decrease in TEWL values and an increase in SC capacitance. CONCLUSION: Combining a topical corticosteroid with corneotherapy agents prevents the delay in the healing process of skin barrier disruption due to ACD.

Administration, Cutaneous↗
PubMed1993

CD23/Fc epsilon R11 expression in contact sensitivity reactions: a comparison between aeroallergen patch test reactions in atopic dermatitis and the nickel patch test reaction in non-atopic individuals.

The immunopathology of patch test reactions to aeroallergens in patients with atopic dermatitis (AD) has been compared to that of contact sensitivity reactions to nickel in non-atopic individuals. Both reactions were found to exhibit equivalent erythema and induration on gross examination at 48 h. Four millimetre punch biopsies were obtained at 48 h frozen, and cryostat sections stained with a panel of MoAbs. The distribution of macrophages, dermal dendritic cells, Langerhans cells, T lymphocytes and the expression of CD23 antigen was recorded. Increased numbers of dermal dendritic cells, macrophages, T lymphocytes and Langerhans cells were found in the dermal infiltrates of both the nickel patch test reactions and the aeroallergen patch test reactions compared with their respective controls. There were no significant differences between atopic patch test reaction and nickel patch test reaction samples in the tissue distribution of these cell types. There was a significant increase in CD23 expression on Langerhans cells and dermal dendritic cells in the atopic patch test reactions, whereas an increase was only observed on dendritic cells in nickel patch test reactions. No significant difference in CD23 expression was observed in the control skin samples taken from patients with AD, nickel-sensitive patients and normal controls. This study supports the hypothesis that the aeroallergen patch test reaction in atopic dermatitis is a delayed hypersensitivity reaction, yet is distinct from the contact sensitivity reaction to nickel in terms of raised expression of CD23.

Adult↗
PubMed2005

A clinical and patch test study of patients with positive patch test reactions to fragrance mix in China.

The clinical and patch test (PT) features of patients with positive PT reactions to fragrance mix (FM) were studied. 378 consecutive eczema outpatients patch tested with a modified European standard series were analysed. 60 patients (15.9%) reacted to FM. No significant differences could be found between the ages of FM PT-positive and PT-negative patients [median age 40.5 (range from 18 years to 69 years) versus median age 37.5 (range from 5 years to 81 years), rank sum test, P = 0.301]. FM PT-positive rate in confirmed non-cosmetic allergic contact dermatitis patients was 30.4%, which was similar to that in confirmed cosmetic allergic contact dermatitis patients (30.4% versus 30%, chi(2) test, chi(2) = 0.0010, P = 0.972). The FM PT-positive rates were 10.8% in males and 18.2% in females (chi(2) test, chi(2) = 3.3443, P = 0.067). 76.7% of the patients with fragrance contact dermatitis were allergic to Chinese traditional medicine, which is much higher than that for cosmetic allergy (76.7% versus 43.3%, chi(2) test, chi(2) = 6.9446, P = 0.008). The positive PT rate to colophonium in the patients with positive PT reactions to FM is higher than that in the FM PT-negative patients (18.9% versus 3.0%, chi(2) test, chi(2) = 15.5471, P < 0.01). 62.5% of the patients reacted to colophonium were positive to FM. These results show that age has little effect on fragrance contact allergy. Other fragrant products besides cosmetics are also important sources of fragrance contact allergy. Chinese traditional medicine was an important factor in fragrance allergy in China. Patients with positive PT reactions to FM are more likely to react to colophonium.

Adolescent↗