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PubMed1985

Lymphocyte subsets and Langerhans cells in allergic and irritant patch test reactions: histometric studies.

This study has attempted to distinguish between allergic and irritant reactions to patch tests by semiquantitative histological methods. The extent of perivascular chronic inflammatory infiltrate at 72 h in irritant patch test reactions to sodium lauryl sulphate was shown to be small and very consistent, whereas in allergic reactions to nickel sulphate it was generally larger and more variable in size (p less than 0.02). The two major lymphocyte subsets (T4 and T8) were randomly intermixed in both types of reaction and formed the major component of both the perivascular and diffuse dermal infiltrate, without any evidence of selective migration. The T4:T8 ratios were similar in focal and diffuse infiltrates. The number of T6 dendritic (putative Langerhans) cells in the epidermis (per mm inner epidermal length) was usually greatly reduced in irritant reactions (5-16 mm-1, mean 10 mm-1) but remained within normal limits in allergic reactions (6-33 mm-1, mean 21 mm-1) (p less than 0.001). Comparable results were seen with other irritants (mercuric chloride and benzalkonium chloride) and other allergens (neomycin sulphate, ethylene diamine and potassium dichromate). In additional experiments, pairs of biopsies were taken from the reaction and from adjacent unaffected skin. The T6 cell density in the epidermis did not significantly differ between allergic reactions and control skin. By contrast, the irritant reactions had fewer T6 cells than the control skin (p less than 0.001).

Dermatitis, Atopic↗
PubMed1986

Expression of OKT6 antigen by Langerhans cells in patch test reactions.

Previous studies in humans and guinea pigs indicate that Langerhans cells (LC) participate in elicitation of allergic contact dermatitis. The number and morphology of LC was determined in acute and healed allergic patch test sites, control (petrolatum) sites and normal skin in nickel-sensitive individuals using OKT6 monoclonal antibody and avidin-biotin/peroxidase labeling. Compared to normal skin, the staining intensity and number of epidermal LC was significantly increased in allergic (p less than 0.02) and petrolatum control (p less than 0.02) sites, and in 6- to 8-week old allergic patch test sites (p less than 0.006). The in situ changes in LC induced by petrolatum alone may be a result of the occlusive patch test, or may suggest that petrolatum is not as neutral as previously believed. The nickel-induced increase in LC may indicate changes in the LC present in the epithelium at the time of testing, or migration of additional LC into the epithelium, which can then remain in situ for weeks after the antigenic challenge. The specificity of the LC increase in allergic contact dermatitis is questioned on the basis of the increase noted with petrolatum.

Adult↗
PubMed1986

Skin reflectance measurements of patch test responses.

Skin reflectance values were used as an objective measure of skin haemoglobin content at patch test sites to facilitate quantification of the erythematous response to contact allergens in patients with allergic contact dermatitis. Reflectance measurements of patch test responses correlated well with the clinical scoring and provided a numerical measure of reaction severity. Experimental contact allergen formulations were also evaluated by this method.

Color↗
PubMed1998

Antiinflammatory properties of cetirizine in a human contact dermatitis model. Clinical evaluation of patch tests is not hampered by antihistamines.

The aim of this double-blind, placebo-controlled, randomized, cross-over pilot study was to assess the antiinflammatory properties of cetirizine. A group of 27 patients with a positive patch test to an allergen consecutively received cetirizine 10 mg o.d. or placebo during a 14-day period, respectively. At day 11 of each period, patch testing was performed with the allergen. The image analysis showed a skin reaction significantly reduced under cetirizine (p = 0.03), but the clinical recording and the standardized chromatometry did not show any difference between groups. In the cross-over analysis the results of image analysis were influenced by the period, but this effect disappeared after adjustment of the ambient temperature during the 3 days of the test. These results demonstrate that cetirizine has an impact on the inflammatory process in a clinical model of cell-mediated allergic reaction, although this effect is only detected with a very sensitive technique. They also show that it is useless to stop antihistamines before patch testing, since clinical evaluation of tests is not hampered by a potent antihistamine. Additionally this study suggests that ambient temperature has an influence on the results of tests.

Adult↗
PubMed2000

Oral lichen planus and the burning mouth syndrome. Is there a role for patch testing?

There is controversy about the role of contact allergy in the pathogenesis of oral lichen planus (OLP) and the burning mouth syndrome (BMS). Patients with OLP or BMS might wish to pursue allergy testing in hopes of identifying the cause of their disease. Although patch testing in these conditions might provide useful information, one risks discovering allergens of uncertain relevance. We asked 2 experts in the field to discuss their approaches to evaluation and management of OLP and BMS, with an emphasis on the role of patch testing.

Burning Mouth Syndrome↗
PubMed1989

Minimum eliciting patch test concentrations of cobalt.

In sensitized subjects, minimum eliciting levels of cobalt were estimated using patch tests with aqueous cobalt chloride on both normal skin and on skin pretreated in various ways to enhance penetration and reactivity. 6 reacted to 10,000 ppm and 1 gave an equivocal reaction to 1000 ppm aq. cobalt. Pretreatment of the patch test site for 24 h with surfactant enhanced reactivity, reducing the minimum eliciting concentration to 1000 ppm cobalt chloride in 1 subject, to 100 ppm in 2 subjects, and in 3 subjects to 10 ppm aqueous cobalt chloride. No reactions were obtained at 1 ppm. EDTA was effective in reducing the response to aqueous cobalt.

Adult↗
PubMed1992

Patch test reactions to metal salts in patients with oral mucosal lesions associated with amalgam restorations.

Patch testing with various metal salts was performed in patients with oral mucosal lesions associated with amalgam restorations, by using polypropylene-coated aluminium discs. Positive reactions to mercuric chloride were obtained in 5/12 (42%) of these patients, but only in 1/11 patients (9%) with oral mucosal lesions unassociated with amalgam restorations and in 3/36 patients (8%) in a control group without mucosal lesions. The difference between the former group and the control patients is statistically significant (p less than 0.05). In addition, a positive test reaction to copper sulfate was obtained in 2 patients (16%) with amalgam-associated mucosal lesions and negative reactions to mercuric chloride. 2 of the 5 positive test reactions to mercuric chloride, in the patients with lichenoid mucosal lesions associated with amalgam, became lichenoid and persisted for at least 3 weeks. The patients with these reactions were also positive at a concentration of 0.05% mercuric chloride, but were negative to metallic mercury, in contrast to 2 other patients in the same group. This indicates the necessity of including mercuric chloride when patch testing such patients.

Adult↗
PubMed2005

[Contact allergens in the standard patch test series from 1980-2004 at the University Clinic Aachen].

Allergic contact dermatitis is a common disease whose specific therapy is avoidance of allergens. It is critical to identify frequency of occurrence of allergic reactions to initiate preventive measures (e.g. elimination of substances with an especially high allergic potential). This study analyzes results of patch testing performed between 1980 and 1993 at the University Clinic of the RWTH Aachen. Additionally, age and sex-related distribution was evaluated. The data is compared to published patch test results covering the years 1995-2001 and patch test results from 2004 in the University Clinic Aachen.

Adolescent↗
PubMed2001

Patch testing and aeroallergen intradermal testing in suspected allergic contact dermatitis, unclassified endogenous eczema and non-atopic chronic urticaria.

The purpose of this study was to investigate the significance of contact allergen and aeroallergen sensitization in suspected allergic contact dermatitis (ACD), unclassified endogenous eczema (UEE) and non-atopic chronic urticaria (NACU). 63 cases of suspected ACD, 140 cases of suspected UEE and 21 cases of suspected NACU were patch tested with the standard series of Beijing Medical University and, if available, suspected materials as is. 22 such cases of ACD, 104 such cases of UEE and 42 such cases of NACU were intradermally tested with common aeroallergens. Patients with non-allergic skin disease served as controls. 85.7% of the suspected ACD patients, 57.9% of the suspected UEE patients and 52.4% of the suspected NACU patients were positive on patch testing, and the results in 81.0% of the suspected ACD patients and 23.6% of the suspected UEE patients were considered relevant. No patch test reactions in the NACU patients were considered relevant. 27.1% of the suspected UEE patients, 41.3% of the suspected ACD patients and 14.3% of the suspected NACU patients reacted to 2 or more contact allergens. High positive rates on aeroallergen intradermal testing were also found in suspected NACU (69.0%), UEE (49.0%) and ACD (59.1%) patients. These results support the conclusions that patients with allergic skin diseases will develop multiple sensitization, and that early detection and avoidance of sensitizing allergens is necessary. The exact rôle of aeroallergen sensitization in these diseases needs further study.

Adult↗
PubMed1980

Comparison of patch test results in two adjacent areas of England. II. Medicaments.

A 3-year study of patch test reactions to the Standard European Battery (S. E. B.) has been carried out in two adjacent areas of South-east England with the same climatic and cultural background. The source of materials and method of testing were identical; all observers have worked together in the same Contact Dermatitis Clinic and the interpretation of reactions can therefore be considered to be consistent. The main differences between the two areas lay in the pattern of employment and in local prescribing habits. Only the second aspect is considered here. Seven allergens--lanolin, neomycin, parabens, iodochlorhydroxyquinoline, ethylene diamine, caine 'mix' and chlorocresol--accounted for approximately 30% of all positive patch test reactions. 'Medicament sensitivity' correlated well with the known prescribing habits of both regions. Certain sites were shown to be especially important in the pathogenesis of medicament contact sensitivity.

Drug Eruptions↗
PubMed1990

[Justification for introducing specific patch test series in the diagnosis of contact allergies].

In contact allergy diagnostic procedures, beside the epicutaneous PATCH testing with commercial products, the authors form a standard as well as a certain number of specific epicutaneus allergen series, in order to prove the relationship between results in two different kinds of investigations, and the justification of testing with certain components of a complex product, in which the causative agent is often presented in a concentration which is lesser than the concentration needed for producing a positive PATCH test. The investigation was done including 158 patients with clinically evident contact dermatitis. TROLABR Hermal-Chemie Kurt Herrmann standard allergens were put in one standard and certain specific series such as: oil and petroleum derivatives and cutting fluids, detergents and soaps, leather, textile fabrics, glues, plastics, protective agents in agriculture, the dentist's battery, cosmetics, hair dressings and hair dyes. Allergic contact sensitivity was detected in 82.2%; in the textile battery (23.01%), in rubber, plastics and glues (15.49%), in cosmetics (12.83%), in oils, petrol derivatives and cutting fluids (12.83%). According to the results in two different kinds of testing and the statistical findings, the relationship between the two variables was estimated with a statistical significance on the level of 0.01.

Allergens↗
PubMed1991

Hyposensitization to urushiol among Japanese lacquer craftsmen: results of patch tests on students learning the art of lacquerware.

8 subjects learning the art of lacquerware were patch tested to urushiol before and after contact with lacquer, in order to document whether hyposensitization to urushiol occurred among Japanese lacquer craftsmen. Simultaneously, we performed patch tests on 2 urushiol-sensitized controls who had no contact with lacquer during the investigation. Lacquer is made from the sap of the Japanese lacquer tree and raw lacquer is composed of 60-65% urushiol and its oligomer. 5 of the 8 subjects showed positive reactions to urushiol 1 month after their first contact. They became negative or less positive after prolonged (9 or 10 months) exposure to lacquer. As reactions to urushiol decreased, dermatitis became less severe. Controls showed consistently high reactions. However, 1 subject showed persistently strong reactions to urushiol. Unlike the other 7 subjects, he was previously sensitized to urushiol before the first contact with lacquer. The remaining 2 subjects showed no reaction throughout our investigation. These results strongly suggest that hyposensitization to urushiol does occur among Japanese lacquer craftsmen.

Adult↗
PubMedDate not supplied

Sensitization to propolis in 1255 children undergoing patch testing.

To investigate the frequency and the features of contact sensitization to propolis in children, we patch tested 1255 consecutive children suspected of allergic contact dermatitis with propolis 20% petrolatum over an 8-year period (1995-2002). Positive responses were observed in 5.9% of patch-tested subjects, with a significantly higher frequency in boys than in girls. The dermatitis was localized mainly on the face, hands and limbs. A significant linear increase in the annual frequency of propolis allergy was noted. Confirming literature data, a significant association with balsam of Peru sensitivity was present in children reacting to propolis, linked to the presence of common constituents in the 2 substances. In conclusion, based on our data, we suggest that propolis should not be used in topical products for children because of its high sensitization rate at the paediatric age.

Allergens↗
PubMedDate not supplied

Relevance of patch testing in patients with nummular dermatitis.

BACKGROUND: A chronic dermatosis like nummular dermatitis may be complicated by contact dermatitis due to an impaired cutaneous barrier. This study is aimed at evaluating secondary contact dermatitis in patients with nummular dermatitis. METHODS: Patch testing with the Indian Standard Series was performed in 50 of 78 patients with a clinical diagnosis of nummular eczema. Significant reactions were graded as per ICDRG criteria. RESULTS: Significant reactions were noted in 23 of 50 tested patients. The most frequent sensitizers were colophony, nitrofurazone, neomycin sulfate and nickel sulfate (7.14% each). Reactions to antigens in topical medications, cosmetics and toiletries constituted 64.28% of all the reactions. CONCLUSIONS: Patients with nummular dermatitis are at significant risk of developing secondary allergic contact dermatitis, which contributes to the severity and chronicity of their dermatitis. Patch testing has the potential to improve the quality of life in these patients. Hence, patients with chronic recalcitrant nummular dermatitis must be patch tested.

Adolescent↗
PubMed1994

[Contact allergy to gold and its alloys. Pertinence of gold salt patch tests].

Allergic contact dermatitis to gold and its alloys is a rare affection and it is difficult to interpret gold salts patch tests. We report two cases of patients with positive patch tests to 0.5% sodium aurothiosulfate discovered during a dermatology exploration of an occupational contact eczema (for the first patient) and an intolerance to gold jewelry (for the second). There is much confusion in the literature concerning the allergologic exploration of contact dermatitis to gold: no standardized test, possible cross reactions between different gold salts, the tests often irritate. The mechanism of sensitization to gold salts is unknown since pure gold is inalterable and does not contain any salts. The pertinence of a positive test to one or more gold salts must therefore be examined carefully and the diagnosis of gold allergy must not be made without sufficient evidence.

Adult↗
PubMed1983

Langerhans cell--mononuclear cell contacts are not specific for allergy in patch tests.

Langerhans cell-mononuclear cell contacts in the epidermis were analysed in minimum positive allergic and toxic patch tests after 6, 12, 24, 48, and 72 hours. No differences between allergic and toxic patch tests were observed in the appearance of Langerhans cells or in the number of Langerhans cell-mononuclear cell contacts. Thus, Langerhans cell-mononuclear cell contacts are not specific for contact allergic reactions, as has previously been suggested.

Allergens↗
PubMed1999

Analysis of aldehyde dehydrogenase 2 gene polymorphism and ethanol patch test as a screening method for alcohol sensitivity.

To assess clinical availability of the aldehyde dehydrogenase (ALDH) 2 gene polymorphism to detect alcohol sensitivity among a Japanese population, we determined the ALDH 2 genotypes and also compared to an ethanol patch test in 119 young Japanese. Their alcohol sensitivity was evaluated by a questionnaire on the frequency of alcohol-associated symptoms when they drink. Genomic DNA was extracted from blood samples and amplified by polymerase chain reaction (PCR). PCR primers were flanking the polymorphic region in exon 12 of the ALDH 2 gene. The distribution of the typical homozygote, the heterozygote and the atypical homozygote was 63.9, 31.9 and 4.2%, respectively. Gene frequencies of the typical and atypical alleles calculated from the genotype frequencies were 0.80 and 0.20. The atypical genotypic homozygotes were positively associated with facial flushing symptom, but not with positive response for ethanol patch test. These results indicate that ALDH 2 genotypes determination is essential to detect alcohol sensitivity whereas the ethanol patch test has some limitations.

Adolescent↗
PubMed1981

Repeated patch testing in penicillin allergy.

Fifteen patients with positive patch test reaction to penicillin preparations were retested several times. This resulted in increasing reactions in eight out of fifteen patients and in decreasing reactions in five patients.

Drug Eruptions↗