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PubMed1992

Patch testing with frullania during a 10-year period: hazards and complications.

Contact dermatitis from frullania mainly affects people living in the country. The 2 most frequent species in Europe, Frullania dilatata and Frullania tamarisci, do not cross-react: both species must be patch tested when frullania intolerance is suspected. Yet patch testing with frullania may be hazardous: 9 out of 37 cases recorded in Strasbourg correspond to active sensitization by the tests. Since routine testing is risky, only aimed testing can be recommended.

Adult↗
PubMed1992

Final diagnoses in patients referred for patch testing.

The final diagnoses made in 989 patients consecutively patch tested in 1990 have been reviewed. Among the men, their dermatitis was entirely occupational in 17.9% and partially so in 12.5%. Among the women, it was entirely occupational in 6.4% and partially so in 9.5%. In both groups, irritants exceeded allergens as the cause, whereas allergens superseded irritants in the patients with a non-occupational eczema caused or aggravated by external factors. It seems likely that domestic irritants were overlooked in patients with a non-occupational dermatitis.

Adult↗
PubMed2002

Importance of chamber size for the outcome of atopy patch testing in children with atopic dermatitis and food allergy.

Because the small backs of young children offer little space for atopy patch testing, it would be helpful to use smaller chambers. We therefore compared 6-mm chambers with the 12-mm chambers used in previous studies. We performed 55 double-blind, placebo-controlled food challenges in 30 children (17 boys, 13 girls) aged 3 to 58 months (median, 13 months). Sensitivity, specificity, positive predictive value, negative predictive value, and efficiency results show that the 12-mm chamber size yields much better results than the 6-mm chamber size. Therefore, 12-mm cups should be used for atopy patch tests with food, even in infants and small children.

Allergens↗
PubMed2001

Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances.

BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer. OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D. METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate. RESULTS: Nine of 10 patients reacted to budesonide and the S diastereomer. Seven of 9 to the R diastereomer. Each of the 9 patients with S diastereomer allergy reacted to the group B and/or group D substances. Five patients reacted to triamcinolone acetonide, not to 1.0% but only to 0.0010% and 0.00010%. CONCLUSION: The R and S diastereomers can induce positive patch test reactions in budesonide-hypersensitive individuals. The potential of budesonide to cross-react with substances from group B and D might be explained by the presence of the 2 diastereomers. When patch testing with triamcinolone acetonide, much lower concentrations than recommended should be used.

Allergens↗
PubMed2005

Atopy patch testing with aeroallergens in patients with atopic dermatitis and controls in Singapore.

The role of allergy in atopic dermatitis is controversial. The atopy patch test (APT) has been used to investigate the association between atopic dermatitis and aeroallergen allergy. To determine the proportion of patients with atopic dermatitis with positive patch tests to common local aeroallergens and to compare this to controls with and without respiratory atopy, we performed APT, skin-prick tests (SPT) and IgE radioallergosorbent tests (RAST) on 73 patients with atopic dermatitis and on 38 nonatopic controls (13 with and 25 without respiratory atopy). The allergens used were house dust mite, cat dander, Bermuda grass and German cockroach. Only the APT for house dust mite showed a significant difference between the two groups. APT for house dust mite correlated with the RAST test, while APT for cat fur correlated with the SPT. The APT may be useful to evaluate aeroallergens in atopic dermatitis, but further work is needed to make it more reliable.

Adolescent↗
PubMed1993

Eczematous skin reaction from patch testing with aeroallergens in atopic children with and without atopic dermatitis.

To determine whether aeroallergens could induce eczematous lesions, 30 patients with atopic dermatitis were studied in comparison with 30 patients with respiratory atopy without atopic dermatitis. All patients were between 2 and 14 years of age. Patch testing with five aeroallergens--housedust, mite, cockroach, mold mix, and grass mix--was done on skin that was stripped by 10 applications of adhesive tape. Intradermal tests with the same antigens were done on the forearm. In 27 (90%) children with atopic dermatitis, patch testing with aeroallergens induced eczematous lesions at one or more sites. Mite, cockroach, house dust, mold mix, and grass mix caused reactions in 21 (70%), 21 (70%), 19 (63%), 15 (50%), and 13 (43%) patients, respectively. Three patients had a dermatitis flare at the antecubital and popliteal fossae during testing. Only three (10%) atopic children without atopic dermatitis had eczematous lesions, which was significantly different from children with atopic dermatitis (P < 10(-6)). Intradermal skin tests in both groups were not significantly different. This study supports previous reports that aeroallergens plays an important role in causing eczematous skin lesions.

Adolescent↗
PubMed1995

Alcohol flushing, patch test, and ADH and ALDH genotypes in Brazilian ethnic groups.

Self reports of flushing reaction after drinking, cutaneous sensitivity to alcohol (patch test), and genotypic determination of ADH2, ADH3, and ALDH2 were studied in 53 Brazilian volunteers of different ethnic groups. Genotypes were determined using single-strand conformation polymorphism in discontinuous buffer electrophoresis. Analysis of the results indicated several cases of a reported flushing reaction among ALDH2 1/1 individuals, while all but 2 cases of ALDH2 heterozygotes reported a flushing reaction. The latter subjects also had a negative result in the patch test. These preliminary results indicate that variability in the facial flushing reaction to alcohol seems to be a phenomenon resulting not only from the presence of a deficient ALDH2*2 allele, but also from other polymorphisms of alcohol-metabolizing enzymes.

Adult↗
PubMed1990

Patch testing of 11 common herbal topical medicaments in Hong Kong.

11 common herbal topical medicaments in Hong Kong were selected for patch testing to study whether they could cause skin reactions under occlusive conditions. These included White Flower Oil, Hung Far Oil, Kwan Loong Medicated Oil, Tiger Oil, Jaminton Oil, Bee Brand Oil, Tiger Balm, Au Kah Chuen Skin Lotions, Mopiko Ointment, OronineH Ointment and Mentholatum. The former 7 were traditional Chinese herbal medicaments, the last one was made in USA and the remaining 2 were Japanese products. 20 patients were patch tested with the 11 medicaments. Hung Far Oil caused mild to moderately severe irritation in 8 patients; White Flower Oil, Jaminton Oil and Tiger Balm caused mild irritation in 1 to 3 patients; and the rest showed no positive reactions at all. With the exception of Hung Far Oil, all the other medicaments should be safe when applied openly. For Hung Far Oil, additional warning as to its irritant properties and the proper method for its application should be provided for the protection of its users.

Administration, Cutaneous↗
PubMed1989

Compound allergy to a skin marker for patch testing: a chromatographic analysis.

We present details of a patient who was demonstrated to have contact allergy to a solution used to mark sites of application of patch tests, during investigation of allergy to gold and nickel. Negative results were obtained when patch testing was performed using the individual constituents of the marker solution (gentian violet, dihydroxyacetone and acetone). Chromatographic analysis of various combinations of these chemicals did not identify a chemical derivative which might have caused this reaction.

Acetone↗
PubMed2004

Determination of skin irritation potential in the human 4-h patch test.

Recently adopted legislation in Europe has increased the focus that must be placed on the development of in vitro alternatives to the traditional toxicology tests employed to identify the human health hazards associated with chemicals. Included in these is the rabbit skin-irritation test which is used to discriminate those substances which possess significant acute skin irritation potential from those which are of more limited irritation potential. So far, the considerable efforts to replace this assay with in vitro alternatives have not been successful, which may in part be due to the relatively poor quality of the existing in vivo dataset. To help address this problem, we have elected to present our complete database of information on the skin irritation potential of some 65 substances, all of which have been tested in a standard human 4-h patch test. These provide a high quality dataset, generated in man (the goal of toxicologists' health protection-related activities). The data are presented in the context of results with a concurrent positive skin irritation control to ensure that results from individual experiments can be correlated. Consequently, in vitro or in silico alternatives which can identify the significant acute human skin irritants in this group may well represent suitable alternatives to the rabbit.

Animal Testing Alternatives↗
PubMed2003

Patch testing with carbamazepine and its main metabolite carbamazepine epoxide in cutaneous adverse drug reactions to carbamazepine.

The value of skin tests in the diagnosis of adverse drug reactions (ADRs) has been limited. Lack of knowledge as to the nature of drug allergens has contributed to these limitations. Several reports have addressed the roles of metabolites in cutaneous ADRs and skin testing. We evaluated the role of a carbamazepine (CBZ) metabolite on the results obtained from patch tests, using CBZ and its main metabolite 10, 11-epoxide of CBZ (CBZ-epoxide), on 13 patients with CBZ-induced drug eruptions and 39 controls with no CBZ-induced cutaneous ADRs. 10 of the 13 patients showed a positive reaction, and 2 of the 10 patients had a reaction to the CBZ-epoxide only and 1 to both CBZ and CBZ-epoxide. None of the 39 controls displayed any reactions to either CBZ or CBZ-epoxide. Patch testing of suspected drugs, as well as their available metabolites, would be helpful in improving the results.

Adolescent↗
PubMed2003

Patch testing for allergic contact dermatitis in the allergist office.

The identification of allergens responsible for allergic contact dermatitis (ACD) is key to the management of this disease. The patch test (PT) is the only safe, objective, scientific, and practical method for the diagnosis of ACD. There is no single PT panel that will screen all the relevant allergens in a patient's environment. It is generally thought that 20 to 30 allergens in routine screening tests can identify 50% to 70% of clinically relevant ACD. However, the usefulness of patch testing is enhanced with the number of allergens tested. Although the PT might be simple to apply, it might be difficult to read, interpret, and correlate to the patient's symptoms. A familiarity with the patient's environment, the process of the industry in that environment, and the uses of various chemicals in the industry is needed in most cases.

Allergens↗
PubMed2006

Atopy patch test with Dermatophagoides pteronyssinus (Dp 1) in atopic dermatitis patients.

The aim of this study was to evaluate the role of Dermatophagoides pteronyssinus (Dp) in atopic dermatitis patients, using atopy patch test (APT) with Dp (extract 1). Twenty patients (males (m) = 9, females (f) = 11, mean age = 46.0 years, range = 19-78 years) with atopic dermatitis were involved in this study. The control group consisted of seventeen healthy subjects (m = 7, f = 10, mean age = 48.3, range = 24-64 years), with no personal or family history and no signs of atopy. Total IgE, specific IgE and a skin prick test were done for all subjects involved in this study. The atopy patch tests were performed with Dp (extract 1) in: 3,000, 10,000, 20,000 and 30,000 biological units per ml (BU/ml) concentrations using glycerol as medium. The total IgE was significantly higher in atopic dermatitis (AD) patients than in a control group with (p < 0.05). After the tests six of twenty patients (30%) had positive APT results in the last two concentrations (20,000 and 30,000 BU/ml). However, all the results were positive after 48 h (and 72 hours), while no positive results were recorded in the control subjects. According to our study, APT with Dp 1 in 20,000 BU/ml and reading time 48 h and 72 hours is to be recommended. The results suggest that APT may detect the trigger factor (Dp) in AD patients.

Adult↗
PubMed2005

Evaluation of the utility of atopy patch testing, skin prick testing, and total and specific IgE assays in the diagnosis of cow's milk allergy.

BACKGROUND: Information on the utility of atopy patch testing (APT) in the diagnosis of food allergy is derived from studies of children with atopic dermatitis. OBJECTIVE: To evaluate the usefulness of APT in the diagnosis of cow's milk allergy (CMA) and to determine interleukin 4 and interferon-gamma production by peripheral blood mononuclear cells. METHODS: Thirty-seven children (median age, 11 months) with suspected CMA who had a variety of symptoms that involved many organ systems were evaluated using double-blind placebo-controlled food challenges (DBPCFCs), and the performances of milk specific IgE, skin prick testing (SPT), and APT were determined. To search for a possible relationship between the diagnostic tests and the TH1/TH2 immune response, we measured interferon-gamma and interleukin 4 levels in the supernatants of peripheral blood mononuclear cell cultures. RESULTS: Seventeen children with positive DBPCFC results and 6 with a history of anaphylaxis were diagnosed as having CMA. The combined use of APT and SPT had a sensitivity of 100% and a negative predictive value of 100% but a specificity of 50% and a positive predictive value of 76%. The addition of milk specific IgE assays to APT and SPT did not improve these values. Pattern of cytokine secretion was not associated with APT positivity or a specific response to DBPCFC. CONCLUSIONS: Atopy patch testing may be a useful adjunct to SPT in excluding CMA in children who have allergic manifestations other than atopic dermatitis. However, DBPCFCs are still necessary in the presence of positive test results.

Animals↗
PubMed1989

Patch tests with occupational contactants in nurses, doctors and dentists.

In this study, 333 nurses, 92 dentists and 167 doctors were investigated. Most positive patch tests obtained were unrelated to occupation. Nurses were most often sensitized to penicillins and, of the disinfectants, formaldehyde was the commonest cause of occupational dermatitis. Among dentists, the most common occupational allergens were eugenol and mercuric chloride. Among surgeons, as compared with physicians, there were frequent reactions to mercuric chloride and balsam of Peru, and a higher number of positive patch tests with other contactants. Among those sensitized to chromium, 4 doctors found that contact with chromic catgut was harmful. 6 other doctors were intolerant to surgical gloves. A number of nurses and doctors had an irritant contact dermatitis from chlorhexidine.

Dentists↗
PubMed2004

Sesquiterpene lactone mix patch testing supplemented with dandelion extract in patients with allergic contact dermatitis, atopic dermatitis and non-allergic chronic inflammatory skin diseases.

We investigated the value of patch testing with dandelion (Compositae) extract in addition to sesquiterpene lactone (SL) mix in selected patients. After we detected a case of contact erythema multiforme after patch testing with dandelion and common chickweed (Caryophyllaceae), additional testing with common chickweed extract was performed. A total of 235 adults with a mean age of 52.3 years were tested. There were 66 men and 169 women: 53 consecutive patients with allergic contact dermatitis (ACD); 43 with atopic dermatitis (AD); 90 non-atopics suffering from non-allergic chronic inflammatory skin diseases; 49 healthy volunteers. All were tested with SL mix 0.1% petrolatum (pet.) and diethyl ether extracts from Taraxacum officinale (dandelion) 0.1 and 3.0% pet. and from Stellaria media (common chickweed) 0.1 and 3% pet. A total of 14 individuals (5.9%) showed allergic reaction (AR) to at least 1 of the plant allergens, 4 (28.6%) to common chickweed extract, and 11 (78.6%) to Compositae allergens. These 11 persons made the overall prevalence of 4.7%: 8 (3.4%) were SL-positive and 3 (1.3%) reacted to dandelion extract. 5 persons (45.5%) had AD, 2 had ACD, 2 had psoriasis and 2 were healthy controls. The Compositae allergy was relevant in 8 cases (72.7%). The highest frequency of SL mix sensitivity (9.3%) was among those with AD. Half the SL mix-sensitive individuals had AD. ARs to dandelion extract were obtained only among patients with eczema. A total of 9 irritant reactions (IRs) in 9 individuals (3.8%) were recorded, 8 to SL mix and 1 to common chickweed extract 3.0% pet. No IR was recorded to dandelion extract (P = 0.007). Among those with relevant Compositae allergy, 50.0% had AR to fragrance mix and balsam of Peru (Myroxylon pereirae resin) and colophonium. SLs were detected in dandelion but not in common chickweed. Our study confirmed the importance of 1 positive reaction for emerging, not fully established, Compositae allergy. In conclusion, the overall prevalence of 4.7% in our study represents a basal SL mix detection rate of 3.4% reinforced and safely supplemented by testing with the dandelion extract.

Adolescent↗
PubMed1987

[Result of patch test and allergic contact dermatitis--statistics over the past six years].

Over the past six years we have practised the examination of standard allergen patch test for patients with allergic contact dermatitis or other contact skin diseases and report the data in this paper. Three hundred and ninety-four patients, who complained of itching and skin legion due to contact with chemical agents were examined. Following the widespread use of the patch test procedure, we used eighteen standard allergenic agents and about eighty percent of these patients showed positive reaction. Furthermore, over fifty percent of the patients manifested positive reaction to the plural allergenic agents. The highest percentage of positive reaction was found in the 30-40 years old patients. Of the series of allergenic agents, urushiol caused the highest positive reaction. Among other agents, metal group, e.g., cobalt chloride, and formalin were also high. Many positive patients to paraphenylendiamine (PPI) were engaged in the occupations associated with PPD. This evidence indicates that the materials that are frequently treated at the place of work or homelife play a major role in the pathogenesis of allergic contact skin diseases.

Adult↗
PubMed1984

Use of buffer solutions for patch testing.

Acid and alkaline products must usually be diluted before patch testing in order to be non-irritant. The use of ordinary solvents for the dilution often means low-concentration products to be tested. By using buffer solutions, the possible test concentrations can be increased at least many hundred fold.

Buffers↗