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At least 433 records · Page 24Linked to original sources
PubMed2006

EAACI/GA2LEN position paper: present status of the atopy patch test.

A number of scientific reports have been published on patch tests with protein allergens performed on patients with atopic eczema (AE). Evaluation of eczematous skin lesions with an atopy patch test (APT) can be used as a diagnostic tool in characterizing patients with aeroallergen- and food-triggered AE. Indications for testing with APT, choice of allergens (aeroallergens and foods), test materials and technique, including present knowledge on sensitivity and specificity, are reviewed on the basis of available literature. This position paper also points out the need for future research on the clinical use of the APT.

Allergy and Immunology↗
PubMedDate not supplied

The MOAHLFA index of irritant sodium lauryl sulfate reactions: first results of a multicentre study on routine sodium lauryl sulfate patch testing.

In a multicentre study of the German Contact Dermatitis Research Group, sodium lauryl sulfate (SLS) 0.25% and 0.5% aq. has been added to routine allergen patch tests to assess its properties as a convenient diagnostic indicator of individual susceptibility to irritation at the time of patch testing. Previous studies indicated that irritant SLS reactivity may be related to individual factors such as age and sex. As these factors are, in turn, among the important predictors of contact allergy to many allergens, e.g. summarized in the 'MOAHLFA index', the impact of the MOAHLFA factors on irritant SLS patch test reactivity, and thus a potential for confounding, was assessed in the 5971 participating patients. As a result of 2 logistic regression analyses with an irritant reaction to 0.25% and 0.5% SLS, respectively, as outcome, male sex was identified as a relatively weak but significant risk factor (OR 1.38), while age 40 years or older was an even weaker risk factor (OR 1.22 and 1.15, respectively). Upon detailed analysis, no clear age gradient could, however, be identified. 1-day exposure time almost halved the odds of an irritant SLS reaction. In conclusion, this type of SLS patch test can be regarded as robust, indicating individual irritability relatively independent from the individual factors analysed here.

Adult↗
PubMed2000

Patch testing with methyldibromoglutaronitrile.

BACKGROUND: The combination of methyldibromoglutaronitrile (MDBGN) and phenoxyethanol (PE) is widely used as a preservative in body care products. Sensitization rates to MDBGN have increased parallel to its increasing use in cosmetics, skin care products, and moist toilet paper since the early 1990s, whereas PE is obviously not a sensitizer. The optimum patch preparation for diagnosing a contact allergy to MDBGN is still a matter of debate. OBJECTIVE: This study was performed to assess an adequate patch test concentration for MDBGN/PE and MDBGN. METHODS: Based on previous results from other countries, the German Contact Dermatitis Research Group (DKG) performed parallel patch tests with MDBGN/PE 0.5% in petrolatum (pet.) and 1% pet. in 4,615 patients and with MDBGN 0.1% pet. and 0.3% pet. in 988 patients. The results of these tests, performed in routine patch testing, were collected and analyzed be the Information Network of Departments of Dermatology (IVDK). RESULTS: Comparing MDBGN/PE 0.5% pet. with 1.0% pet., the percentage of patients showing a positive test reaction increased from 2.3% to 3. 5% (P <.001), mainly because of an increase in weak positive reactions. The reaction index remained stable at 0.54. Comparing MDBGN 0.1% pet. with 0.3% pet., the percentage of patients with positive reactions increased from 1.4% to 3.3% (P <.001), and the reaction index decreased from 0.33 to -0.10. With the lower test concentration, 79% of the positive reactions were only +, with the greater concentration, this was true of 64%. CONCLUSION: Testing MDBGN/PE 1.0% pet. shows additional cases of contact allergy to MDBGN that would have remained undetected with MDBGN 0.5% pet. The greater test concentration seems to have no disadvantages in quality. The DKG decided to keep MDBGN/PE 1.0% pet. in the standard series. MDBGN 0.3% pet. leads to far more doubtful or irritant test reactions than MDBGN 0.1% and may produce false-positive patch test results. Therefore, the DKG recommends testing MDBGN 0.3% pet only in special cases.

Cosmetics↗
PubMed1995

Evaluation of patch test results by use of the reaction index. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK).

Results of patch tests performed in 15,553 patients by 18 dermatological departments (members of the German Contact Dermatitis Research Group) and recorded by the Information Network of Departments of Dermatology (IVDK) were analysed by comparing recently defined reaction indices (RIs). The RIs studied were calculated from the numbers of allergic (a), questionable (q), and irritant (i) reactions (RI = (a-q-i/(a + q + i)), which were obtained using 13 European standard allergens. RIs were calculated for all patients and for separate subgroups defined by age, sex, history of atopic dermatitis, time of allergen exposure (1 versus 2 days), and time of patch test reading (2 or 3 days after allergen application). Higher RIs were consistently obtained when patch tests were applied for 1 day, as compared to 2 days. Readings at 3 days after allergen application resulted in higher RIs than readings after 2 days. In contrast, sex, age, and history of atopic dermatitis of patients were not found to have a consistent influence on the RIs. We suggest that reading after 3 days should be obligatory, and that allergen exposure for 1 day instead of 2 days might make patch test evaluation easier. These suggestions need to be substantiated by data on clinical relevance.

Adult↗
PubMed1977

Immediate reactions to patch tests with balsam of Peru.

Closed patch tests with balsam of Peru gave rise to nine immediate reactions among 121 patients with different dermatoses and to 10 reactions among 57 patients with chronic urticaria. Among compounds of balsam of Peru, cinnamic aldehyde, cinnamic acid benzoic acid and benzaldehyde also gave the same reactions. The reactions could not passively be transferred with serum from patients. They were abolished by antihistamine given before testing, and by pretreatment with compound 48/80. Balsam of Peru and cinnamic aldehyde did not provoke new symptoms when given orally to patients.

Balsams↗
PubMed1998

Nickel content of standard patch test materials.

The nickel sulfate content in standard patch test materials currently used in the US, Europe and Japan was determined by inductively-coupled plasma atomic emission spectroscopy, a state-of-the-art microanalytical method which allows nickel detection to levels of 7 ppb (microg/l). In 2 materials with a nominal concentration of 5% nickel sulfate hexahydrate in pet., the range (calculated averages of triplicate analyses of 3 different batches) was from 4.72 to 4.87% and 4.97 to 5.39%, respectively. In 1 material with a 2.5% nominal concentration in pet., the values ranged from 2.41 to 2.48%. The range seen in a 5% NiSO4 hexahydrate aq. material was 4.95 to 5.03%. The range for 2.5% NiSO4 anh. in pet. was 2.39 to 2.49%. This data suggest a significant improvement in quality control compared to our previously published data.

Allergens↗
PubMed1993

The technique of patch testing: role of the office staff.

Patch testing is a very useful office diagnostic tool to help clarify the cause of allergic contact dermatitis. The dermatology nursing staff can help the physician with some of the time-consuming steps in using this technique, which can be very valuable to patient outcome.

Dermatitis, Contact↗
PubMed1983

Eugenol and clove leaf oil: a survey of consumer patch-test sensitization.

The potential of eugenol and of clove leaf oil, which contains a high concentration of eugenol, to induce delayed skin hypersensitivity or to elicit reactions due to pre-existing skin sensitization in man was evaluated by analysing patch-test data. Results from a total of 11,632 patch tests on eugenol itself, on various consumer products containing eugenol and/or clove leaf oil, and on fragrance blends containing eugenol and/or clove leaf oil were collected from fragrance and formulation companies. One instance of induced hypersensitivity and one instance of pre-existing sensitization were observed at eugenol patch-test concentrations of 5 X 10(-2) and 9 X 10(-2)% respectively. In both cases, subsequent patch testing showed skin responses to mixtures of eugenol and isoeugenol, but no further attempt was made to define the causative agent. The survey indicates that, at the concentrations present in consumer products, eugenol alone or as part of clove leaf oil has a very low potential either to elicit pre-existing sensitization ('elicited' reactions) or to induce hypersensitivity ('induced' reactions).

Dermatitis, Contact↗
PubMed1984

Patch test allergens in petrolatum: a reappraisal.

Patch test materials in petrolatum, from 3 different manufacturers and 14 different types were evaluated by gross and microscopic examination. The allergens were noted to be suspended as particles or droplets in the vehicle. Obvious variations in both size and structure of the included allergen were found with the same chemicals but of different manufacture. Several materials do not meet the pharmaceutical standards which should be requested regarding stability, particle size and packing. A more detailed declaration is proposed.

Allergens↗
PubMed2005

Common contact sensitizers in the Czech Republic. Patch test results in 12,058 patients with suspected contact dermatitis*.

The patch test results of 12 058 patients (4416 male and 7642 female) referred to 9 clinics in the Czech Republic between January 1997 and December 2001 were evaluated. Patients were tested with the same series of allergens by using the standardized patch testing method. The current standard tool for diagnosing allergic contact dermatitis (ACD) in the Czech Republic is the Trolab test panel (Hermal, Reinbeck, Germany) which consists of 23 allergens. Only a few data exists on ACD in the Czech Republic. All patients were tested with the 23 allergen European standard series. Of these patients, 7661 (63.5%) had 1 or more positive reactions. On average, there were 2.8 positive reactions per patient. ACD, according to clinical relevance, was diagnosed in 5339 (69.7%) of these patients. The most frequent allergens were metals (22.9%), especially nickel sulfate (13.8%), and followed by Myroxylon pereirae resin (balsam of Peru) (7.3%), fragrance mix (5.8%), formaldehyde (4.2%) and lanolin alcohol (3.0%). Our results were compared with results from other countries. We conclude that the European standard series is suitable for detection of ACD in the Czech Republic.

Adolescent↗
PubMed1983

Benzyl salicylate: a survey of consumer patch-test sensitization.

The potential of benzyl salicylate, an important fragrance and flavour ingredient, to induce hypersensitivity or to elicit reactions to pre-existing hypersensitivity in the general population was evaluated by analysing patch-test data. Results obtained from fragrance and formulator companies for a total of 10,538 patch tests on benzyl salicylate alone, on a variety of household and personal care consumer products and on fragrance blends containing benzyl salicylate were analysed as part of this survey. No induced or elicited responses directly attributable to benzyl salicylate were observed in the 35 patch tests on benzyl salicylate alone, or in the 10,503 patch tests on consumer products or fragrance blends containing benzyl salicylate. The highest concentration of benzyl salicylate tested in the consumer-product tests was 2 X 10(-1)%, and benzyl salicylate alone was tested at 10% in ethanol. This study indicates that benzyl salicylate has a very low potential to induce hypersensitivity ('induced' reactions) or to elicit reactions presumably attributable to pre-existing sensitization ('elicited' reactions) and thus supports the safe use of benzyl salicylate in consumer products and fragrance blends.

Dermatitis, Contact↗
PubMed1983

Influence of detergent washing powders on minimal eliciting patch test concentrations of nickel and chromium.

Minimum eliciting levels of nickel have been estimated in 25 nickel-sensitive subjects, and of chromium in 14 chromium-sensitive subjects by patch tests with aqueous solutions of the respective metals. The minimum level of each metal required to provoke a patch test reaction was considerably greater than that found in fabric washing powder solutions and was in the majority of patients tested of the order of 112 ppm nickel (0.05% nickel sulphate) or 885 ppm hexavalent chromium (0.25% potassium dichromate). One nickel-sensitive subject and one chromium-sensitive subject reacted to 1 ppm of the respective metal. Fabric washing powder did not significantly alter the patch test reaction to nickel sulphate or provoke reactions in nickel- or chromium-sensitive subjects. EDTA significantly reduced the number and severity of patch test reactions to nickel sulphate but not those to potassium dichromate or trivalent chromium.

Chlorides↗
PubMedDate not supplied

Patch-testing with serial dilutions of tixocortol pivalate and potential cross-reactive substances.

Of patch-tested patients with dermatitis, 4-5% are allergic to corticosteroids. Four groups of corticosteroids are recognized (A-D), where substances from the same group may cross-react. We investigated the potential cross-reactivity pattern and dose-response relationship for several corticosteroids from group A. We also included the corresponding aldehyde to hydrocortisone, as this degradation product has been proposed to be immunogenic. Eleven patients shown to be allergic to tixocortol pivalate were patch-tested with several corticosteroids from group A, as well as with the aldehyde, all in serial dilutions. All 11 reacted to both tixocortol pivalate and hydrocortisone. The dose-response relationship for the corticosteroids tended to be similar to sensitizers lacking anti-inflammatory potential. Patients with simultaneous reactions to many substances had high patch-test reactivity to tixocortol pivalate and hydrocortisone, while patients with few such reactions showed low reactivity (p=0.001 and 0.003, respectively). Several patients reacted to the aldehyde, supporting the theory that it is an intermediate in sensitization.

Administration, Topical↗
PubMed1999

Patch testing in a British district general hospital.

The results of patch testing in 753 patients attending a dermatology clinic in a British district general hospital over the period 1993-96 are presented. The frequency of positive reactions, and of the relative frequency of common allergens is broadly comparable to series published from specialist contact clinics. This study suggests that nonspecialist dermatology clinics can carry out routine patch testing adequately, although there are likely to be a number of cases which will require review in a specialist clinic or specialist advice.

Ambulatory Care↗
PubMed2004

Positive patch tests to Euro coins in nickel-sensitized patients.

BACKGROUND: Many efforts have been made to prevent nickel allergy, the most frequent contact allergy in industrialized countries, by identifying acceptable limits of exposure. Even though coins are not covered by the EU Nickel Directive, some authors suggest that nickel release from coins during handling may elicit contact dermatitis in nickel-allergic people. OBJECTIVES: To evaluate sensitivity to nickel released from coins in nickel-allergic patients and to verify whether nickel release from the new Euro coins may elicit stronger cutaneous reactivity than from old Italian lire coins. METHODS: Twenty-five nickel-allergic patients were patch tested with 1- and 2-Euro coins, 1-, 2- and 50-Euro cent coins, and 100 and 500 Italian lire coins. Ten healthy nonnickel-allergic control individuals were also tested. RESULTS: Nineteen patients had positive patch tests to 1- and 2-Euro coins. One was also positive to 1- and 2-Euro cent coins, four to 50-Euro cent coins, and 13 to the 500-lire coin. None had a positive patch test to the 100-lire coin. The number and degree of positive patch tests to coins were related to nickel content. CONCLUSIONS: Euro coins may be potentially more dangerous than old Italian coins. Coins containing little or no nickel should be chosen for coinage to prevent sensitization and to avoid exacerbation of contact dermatitis in nickel-allergic patients.

Adolescent↗
PubMed2002

Patch tests with thiurams at 0.25% pet. and 1% pet. are of equal diagnostic value.

Thiuram mix is tested in the standard series at a test concentration of 1% pet. The single thiurams (DPTD, TMTD, TMTM, TETD), however, are usually tested at 0.25% pet. in Germany. In other countries, the individual components of thiuram mix are tested at 1% pet. The German Contact Dermatitis Research Group (DKG) compared both patch test concentrations in 530 patients in order to find out if (i) a significant number of positive patch tests are missed by testing at the lower concentration, (ii) problems with irritant test reactions occur by increasing the test concentration to 1%, and (iii) the sensitivity of the thiuram mix rises when the breakdown test is done with the higher concentration. Slightly more positive reactions were seen with the higher concentration, but this increase did not reach statistical significance. The reaction index, as a measure for the relation of positive to irritant and/or questionable reactions, remained unchanged for the individual thiurams. The sensitivity of the mix also did not change when the breakdown test was performed with 1% pet. instead of 0.25% pet. Thus, we conclude that both concentrations are of equal diagnostic value in patch testing.

Dermatitis, Allergic Contact↗
PubMedDate not supplied

Contact sensitization in 1094 children undergoing patch testing over a 7-year period.

Contact sensitization in children is frequent. However, because exposure to sensitizing agents varies rapidly, it is of utmost importance to perform a periodic evaluation of patch test results. Our purpose was to compare our data on contact sensitization in children during the past 7 years to our previous 1988-1994 findings, in order to identify emerging allergens and update our pediatric series. From 1995 to 2001, 1094 consecutive children were examined. Of these, 997 patients were patch tested with our pediatric series, which includes 30 allergens, whereas 97 underwent patch testing with 46 allergens. A total of 570 children proved allergic (52.1%). The highest sensitization rate was observed in children under 3 years of age. No differences between atopic dermatitis patients and nonatopic ones were observed in the sensitization rate. Neomycin, nickel, wool alcohols, thimerosal, and ammoniated mercury gave most of the positive responses. With respect to 1988-1995 data, allergy to substances such as neomycin, nickel, wool alcohols, thimerosal, ammoniated mercury, propolis, potassium dichromate, and thiuram mix proved more frequent. In conclusion, as sensitization rates to different allergens show great variations over time, periodic evaluations of patch test results in children is necessary in order to update the test trays.

Allergens↗
PubMed2000

[Contact dermatitis due to ethyl alcohol: how to perform patch tests?].

INTRODUCTION: Ethyl alcohol sensitization is rare and can induce immediate contact urticaria or delayed eczema. Patch tests performed with ethanol can provoke an irritative reaction and are not well codified. CASE-REPORTS: We report on 4 cases of contact dermatitis due to alcohol in 4 women. Eczema was due to alcohol contained in the reservoir of a transdermal transfer system with estrogens in 2 cases and related to the application of alcoholized antiseptic lotions in the other 2 cases. In 2/4 cases we observed a co-sensitization with corticosteroids. METHODS: Patch tests were performed with alcohol at 95 degrees diluted at 70 p. 100 and at 10 p. 100 in water and read after 20 minutes then on day 2 and day 4. RESULTS: Positive results were obtained in 4/4 cases when alcohol was tested diluted at 70 p. 100 in water and in 3/4 cases when diluted at 10 p. 100 in water. No irritant reaction was observed in 140 negative controls. DISCUSSION: Immediate after 20 minutes and delayed readings of patch tests performed with ethyl alcohol diluted at 70 p. 100 seem to be convenient in diagnosing cutaneous delayed hypersensitivity to alcohol. Co-sensitization between corticosteroids and alcohol could be due to an aldehyde deshydrogenase deficiency.

Administration, Topical↗