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PubMed1976

[Improvement of the patch-test reading through contact thermography].

The evaluation by contact-thermography (with heat sensitive cholesterinester crystals) of patch tests for contact dermatitis is an important aid to detect weak positive or false negative reactions. In addition, it facilitates the interpretation of patch tests in dark skin persons. The number of diagnosed cases of contact dermatitis can be increased by about 10% without increasing the expenditure of time on the part of the patient or the physician.

Dermatitis, Contact↗
PubMedDate not supplied

Skin disorders and prick and patch test reactivity in Finnish reindeer herders.

In addition to an interview, skin tests and clinical examinations were performed on 211 randomly selected reindeer herders from 21 to 77 years of age (mean 45 years). Skin tests consisted of skin prick tests (SPT) with 9 allergens: cat and cow epithelium, dog, horse and reindeer epithelium, house dust mite, birch pollen, meadow grass pollen and mugwort pollen, as well as patch tests with 31 allergens. Of the 211 tested, 19 (9%) had positive SPT reactions to at least one allergen, and 19/173 (11%) showed a positive patch test result. Thirty-six of the 211 (17%) had past or present atopic dermatitis. These findings suggest that the prevalence of immediate and contact allergies and skin diseases is roughly the same as that of other Finns. A positive SPT reaction to birch pollen was encountered less frequently than in a previous Finnish study conducted in southeastern Finland.

Adult↗
PubMed1992

Results of routine patch testing of 834 patients in Turin.

834 consecutive patients (630 female), aged between 26 and 46 years, who were suspected of having allergic contact dermatitis were patch tested with the GIRDCA standard series during 1989-1990. The most frequent sensitizers observed included nickel sulphate, cobalt, Kathon CG, perfumes, potassium dichromate and balsam of Peru. We have evaluated the influence of individual factors such as sex, age and occupation on the patch test results, and the coexistence of 2 or more unrelated but statistically significant sensitivities.

Adult↗
PubMed1991

Cell trafficking in positive and negative patch-test reactions: demonstration of a stereotypic migration pathway.

The cellular and molecular events taking place during epidermal antigen exposure in sensitized individuals are principally well understood. Epidermal Langerhans cells (LC) are supposed to take up, process, and express a given foreign substance on their cell surface. The antigen is then recognized by T cells bearing the appropriate T-cell receptor (TCR). Because LC do not bear variable antigen (Ag)-specific binding sites, one could postulate that the epidermal exposure of any substance should activate LC and other cells of the skin immune system. To test this hypothesis, we analyzed immunophenotypically the cellular trafficking events in positive (n = 5) and negative epicutaneous patch-test reactions (n = 10), using a panel of monoclonal antibodies against CD1a, CD11c (Ki-M1, LeuM5), CD68 (Ki-M6), Ki-M8, and CD3 (Leu4). We can demonstrate that irrespective of whether or not an antigen will be responded to by the immune system (i.e., positive or negative test reaction), epidermal antigen exposure causes a decrease of LC density in the epidermis and simultaneously causes an increase of LC in the dermis. Moreover, monocytes and T cells immigrate into the dermis both in positive and negative patch-test reactions. As is to be expected, the degree of this cellular traffic is more pronounced in positive test reactions, which may be due to amplification mechanisms caused by antigen recognition of sensitized T cells. This finding demonstrates that human skin contains cell migration programs that ensure that any foreign substance will be accessible to the skin immune and phagocytic system.

Antibodies, Monoclonal↗
PubMed2001

Another look at seasonal variation in patch test results. A multifactorial analysis of surveillance data of the IVDK. Information Network of Departments of Dermatology.

There is conflicting evidence concerning seasonal variability of patch test results and no evidence concerning the influence of season on weak-positive, possibly false-positive, irritant reactions, which was analysed in the present study. Data collected in the German Information Network of Departments of Dermatology (IVDK) 1992 to 1997 were combined with external environmental data on temperature and absolute humidity in Germany, and bivariate as well as logistic regression analyses performed concerning the association between reactivity to selected allergens and air temperature and absolute humidity on the respective days of patch testing. Between 39,239 and 41,629 patients had been tested with the 4 allergens considered here. Only formaldehyde exhibited a distinct increase in questionable or irritant as well as weak-positive reactions associated with dry, cold weather. Methylchloroisothiazolinone/methylisothiazolinone and lanolin alcohol showed only a weak, and epoxy resin no, association with climatic conditions. The results indicate that weak-positive reactions, at least to formaldehyde as a prototype of an allergen which is at the same time a marginal irritant, may sometimes be irritant rather than allergic. Patients showing these should be re-tested to improve the poor reproducibilty observed with this allergen.

Climate↗
PubMed1995

Evaluation of variables influencing the outcome of the atopy patch test.

BACKGROUND: The number of positive atopy patch test (APT) results in patients with atopic eczema (AE) varies in different studies, probably because of different test techniques. Variables that may influence the outcome of the APT were evaluated. METHODS: APTs were performed in 84 patients with AE, 30 control patients with atopic disease, and 85 healthy volunteers, with house dust mite and grass pollen allergens in concentrations of 100, 1000, 10,000, and 100,000 allergenic units/ml. The influence of 0, 10, or 20 tape strippings was investigated. The tests were performed on the back and/or the antecubital fossa and evaluated after 20 minutes and 24, 48, and 72 hours. In all patients the total and specific serum IgE levels were measured. RESULTS: The maximal number of positive APT results were obtained under the following conditions: an allergen concentration equal to 10,000 allergenic units/ml, 10 tape strippings and readings at 24 and 48 hours. Positive APT results were observed in five of 30 control patients with atopic disease and in none of 85 healthy volunteers. Statistically significantly higher total and allergen-specific serum IgE levels were found in the group of patients with AE with positive APT results. CONCLUSIONS: We recommend the previously described conditions to get an optimal method for APT. The correlation between the APT and the total and specific serum IgE suggests an important role for IgE in the reaction mechanism behind the APT.

Adult↗
PubMed1985

Disodium cromoglycate inhibits allergic patch test reactions.

Disodium cromoglycate was applied before patch testing in patients with contact allergy to propipocaine hydrochloride, nickel and formaldehyde. The responses obtained were mitigated to a high degree when compared with similar effects due to corticoids.

Allergens↗
PubMed1990

Patch testing with the "sesquiterpene lactone mix": a marker for contact allergy to Compositae and other sesquiterpene-lactone-containing plants. A multicentre study of the EECDRG.

6278 patients were patch tested with a sesquiterpene lactone mix (SL-mix) in 10 European clinics. 4011 patients were tested only with 0.1% SL-mix, 63 (approximately 1.5%) of whom were positive, with 26 (41%) of these cases being considered clinically relevant. There were no cases of active sensitization, though 5 cases of irritation were reported. 22 irritant reactions and 22 cases of active sensitization occurred when testing also with 1% and 0.33% concentrations of SL-mix. SL-mix 0.1% pet. is shown to be an important patch test and many relevant sensitizations will be missed without routine screening with such a mix. Most patients with SL-mix sensitivity presented with hand and/or face dermatitis, apparent photodermatitis or more generalised eczema.

Dermatitis, Contact↗
PubMed1984

24 and 48 h allergen exposure in patch testing. Comparative study with 11 common contact allergens and NiCl2.

Patch test reactions to 11 common contact allergens were studied after 24 h and 48 h occlusion with Finn Chambers in 390 patients. Concordant allergic results were found in 96 cases (74%). In 22 patients (17%), the reaction was positive only after 48 h and in 11 cases (8.5%) only after 24 h exposure. Most of the discordant reactions were to nickel, cobalt, neomycin, formaldehyde and perfume mix. Irritant reactions were found in 55 cases, the majority occurring after 48 h occlusion. Nickel chloride tested in parallel with 48 h exposure lead to more positive allergic and toxic reactions than nickel sulphate.

Allergens↗
PubMed2000

The results of ingredient patch testing in contact dermatitis elicited by povidone-iodine preparations.

10 cases of contact dermatitis which began during the application of povidone-iodine preparations were examined with patch tests using 2 kinds of povidone-iodine preparations and their ingredients, i.e., povidone-iodine, polyoxyethylene nonylphenyl ether and glycerin, and also the components of povidone-iodine, i.e., iodine and polyvinylpyrrolidone. All 10 cases reacted positively to the povidone-iodine preparations and povidone-iodine, 3 out of the 10 to polyoxyethylene nonylphenyl ether, 1 out of the 9 tested to iodine, while no positive response was found to glycerin or polyvinyl-pyrrolidone. It was difficult to distinguish between allergic responses from irritation, as responses to patches of povidone-iodine and its preparations usually include irritation at high frequencies. Based on comparison of results with a control group, however, those showing + or stronger reactions to 2% povidone-iodine at days 3 to 5 were considered to be allergic. Thus, 4 out of the 10 cases were considered as sensitization to povidone-iodine. Another 3 cases were found to be polyoxyethylene nonylphenyl ether sensitized, and another 1 iodine sensitized, while the patch test reactions of the other 2 were considered to have been elicited by irritation.

Adult↗
PubMed1997

Results of patch testing with a specialized collection of plastic and glue allergens.

Patch testing was performed on 235 patients with a specialized collection of plastic and glue components. Thirteen percent had a positive response to at least one of the allergens. Seventy-four percent of the responses were relevant to either the present or a past problem, and 64% were occupationally related. The substances that yielded the greater percentage of positive responses were ethylenediamine, triethylenetetramine, diethylenetriamine, diaminodiphenylmethane, melamine formaldehyde resin, phenol formaldehyde resin, cresylglycidylether, phenylglycidylether, and N, N-dimethyl-p-toluidine. Of the 47 agents used, 26 did not elicit any positive responses. There were few distinguishing characteristics between those who exhibited a positive response to these agents and those who did not. In 12 cases (5% of those tested), the diagnosis of allergic contact dermatitis would have been missed if the plastics and glues components were not used.

Adhesives↗
PubMed1978

Day 7 (D7) patch test reading - valuable or not?

Day 7 (D7) reading of 15,469 patch tests was carried out in 499 patients. In one fifth of them, positive reactions were observed at D7 having been judged negative at D2. The significance of the findings is discussed.

Adult↗
PubMedDate not supplied

Patch testing of Singapore children and adolescents: our experience over 18 years.

This is a retrospective epidemiologic study of allergic contact dermatitis in children and adolescents in Singapore who had undergone patch testing from January 1, 1986 to December 31, 2003. A total of 2,340 patients below the age of 21 years had undergone patch testing. Of these, 1,063 (583 girls, 480 boys) were positive to one or more allergens. The most common allergens were: nickel (40%), thimerosal (15%), colophony (9%), lanolin (8%), cobalt (8%), fragrance mix (5%), and neomycin (4%). Each of these allergens will be discussed individually. This is the first study with over 1000 patients on this subject from Asia.

Adolescent↗
PubMed1987

Selection of patch test materials for gold allergy.

Allergic contact dermatitis to gold is very rarely reported. The occurrence of 2 recent cases in our department prompted a review of the literature, especially regarding the optimal reagents for patch testing. Gold chloride is most commonly used but may cause persistent dermatitis at the test site. Gold sodium thiosulfate is commercially available in petrolatum and is a reliable, non-irritant preparation for patch testing.

Adult↗
PubMed1984

Standard patch tests in agricultural workers.

The results obtained with a standard patch test series in a group of agricultural workers is compared with a control group. Statistically significant differences in the frequency of several allergens were found. The possible causes of these differences are discussed.

Agricultural Workers' Diseases↗
PubMed2006

[A case report of a metal allergy patient whose prosthesis was identified allergenic by non-destructive metal element analysis and a dermatological patch test].

PATIENT: A 70-year-old man. Eczema of the palm (Pustulosis palmaris et plantaris). A positive response to chromium was identified by a dermatological patch test. Metal elements used in his dental restorations were analyzed by non-destructive metal element analysis, and chromium was identified only in the porcelain-fused-to-metal crowns restored in his maxillary central and lateral incisors and canines. Resin facing crowns made of a gold, silver and palladium alloy were installed after those crowns were removed. DISCUSSION: With all of the interviews performed with this patient, identification of the allergenic restoration in his mouth was difficult. For this kind of metal allergy patient, a combination of metal element analysis of intra-oral restorations with a dermatological patch test seems to be very useful. CONCLUSION: This patient's allergic symptoms were ameliorated with minimal selective removal of his intra-oral metal restorations by non-destructive, intra-oral metal element analysis.

Aged↗
PubMed1987

Allergy to local anesthetics: comparison of patch test with prick and intradermal test results.

The interrelation between immediate and delayed hypersensitivity reactions to local anesthetics is poorly understood. Especially, the relevance of positive patch test reactions to local anesthetics with regard to the compatibility of injected local anesthetics is unclear. We therefore subjected 104 patch test-positive probands to prick and intradermal tests with seven local anesthetic agents. All prick tests were negative. Only 14 patients showed positive reactions in intradermal tests: 11 with the ester local anesthetic procaine, one with the amide local anesthetic butanilicaine, and two with both. Procaine yielded both immediate and delayed reactions; butanilicaine, only immediate reactions. All other local anesthetics showed negative reactions. It is concluded that in patients with positive patch test reactions to local anesthetics and negative history of anaphylactoid reactions, positive skin test reactions to intradermal application are rare and that, therefore, the risk of anaphylactic reactions to injection anesthesia with amide local anesthetics, except butanilicaine, appears low in these patients.

Adult↗
PubMed2002

Patch test reactions to Biobans in metalworkers are often weak and not reproducible.

Contact allergy to the industrial preservative group of Biobans has been reported in individual cases. We have performed a prospective study on 408 metalworkers who were tested with 6 different Biobans, formaldehyde and 5 other preservatives. Furthermore, retesting was performed after a time interval of 6 months to 4 years. The test results were also compared with those of the multicentric data provided by the Information Network of Departments of Dermatology in Germany and Austria (IVDK), particularly with regard to cross-reactivity between the various Biobans and formaldehyde. In 408 metalworkers 14 (3.4%) showed positive reactions to Biobans (2.2% P 1487, 2.0% CS 1246, 1.5% CS 1135), the majority being + reactions. On retesting 10 patients, the reactions were confirmed in only 2 cases (P 1487 and CS 1135). 4 patients showed positive reactions to 3 Biobans (P 1487, CS 1135, CS 1246), while 9 patients had only solitary sensitizations. Concomitant sensitization to formaldehyde was present in 5 out of 10 patients, being reproducible in 3 of them. In the IVDK data, sensitization prevalence in 3400 patients ranged from 1.8% (P 1487) to 0.8% (CS 1246). A high proportion of doubtful or irritant reactions as well as weak + reactions was observed. Cross-reactivity between the various Biobans was low, moderate agreement being calculated for CS 1135 and CS 1246 (kappa coefficient 0.43). The consensus pattern between formaldehyde and the tested Biobans was even lower. In conclusion, patch test reactions to Biobans are not rare among metalworkers but are often weak and not reproducible. Simultaneous reactivity to various Biobans and formaldehyde may be due to cross-reactivity or cosensitization from common exposure.

Allergens↗