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PubMed1990

Influence of topical metal binding substances, vehicles, and corticosteroid creams on the allergic patch test reaction in metal-sensitive patients.

Persons known to be allergic to nickel, cobalt, or both were patch tested with serial dilutions of cobalt chloride or nickel sulfate either in petrolatum on skin treated with topical preparations with and without metal-binding compounds or incorporated into such special preparations. A decreased response was found in patients tested with Vioform (clinquinol) and cobalt chloride simultaneously, whereas rutin (3,3',4',5,7-pentahydroxyflavon 3-rhamnoglucosid) increased the response, and polyfloretin phosphate had no effect. The vehicles proved significant: "Ung Merck" and "W/O Cream Base" increased reactivity, whereas polyethylene glycol gave good protection against metal ions. As expected, corticosteroid creams suppressed the inflammatory response.

Administration, Topical↗
PubMed2001

Positive patch-test reactions to para-phenylenediamine, their clinical relevance and the concept of clinical tolerance.

406 patients were patch tested over an 18-month period (January 1998 to June 1999) at a dermatology referral centre. 33 patients (8.1%) had a positive reaction to para-phenylenediamine (PPD). 20 patients were experiencing PPD hair dye dermatitis (present relevance, 61%), 2 were using PPD hair dyes without developing dermatitis (clinical tolerance, 6%), 4 had previously used PPD hair dyes with dermatitis in the past (past relevance, 12%), 3 had previously used PPD hair dyes without dermatitis (past exposure, 9%) and 4 had no known exposure to PPD (unknown relevance, 12%). Of the 20 patients whose test results were of present relevance, 17 avoided PPD hair dyes, resulting in total clearance of the dermatitis in all except 3, who had concurrent endogenous eczema. 3 continued using PPD hair dyes: 2 had recurrent contact dermatitis and 1 avoided dermatitis with meticulous technique. The 2 patients with clinical tolerance continued using PPD hair dyes with no dermatitis.

Adult↗
PubMed2005

Cumulative irritation patch test of sanitary pads on sensitive skin.

BACKGROUND: Tools are needed to assess the effects of various products on sensitive skin. AIM: To investigate the cutaneous compatibility of various sanitary pads in people with self-declared sensitive skin. PATIENTS/METHODS: Eight subjects, who considered their skin to be sensitive and who reported adverse skin responses to everyday products or clothing, were patch tested on the arm with two, low-irritancy sanitary pads for four consecutive 24-hour periods. Test products differed only in their surface covering. Sodium lauryl sulfate solution (0.1% w/v) and physiological saline served as standard irritant and nonirritant controls, respectively. Skin irritation (erythema) was graded after each 24-hour period. RESULTS: No significant difference in skin erythema scores was observed between groups (scores on day 4: 1.06 +/- 0.11 vs. 1.25 +/- 0.13, on a five-point scale, P < 0.05). The temporal development of cumulative irritation associated with the pads was comparable to that observed with the nonirritant control (a plateau in maximal group scores) and distinct from that of the irritant control (continuously rising scores). CONCLUSION: Sanitary pads under investigation elicited negligible cumulative irritation in a four-day patch test on subjects with self-declared sensitive skin. The temporal pattern of cumulative response was consistent with the inherently low irritation potential of the products.

Journal Article↗
PubMed1983

Patch testing with substances not included in the standard series.

During a 5-year period, 3664 consecutive patients were patch tested in a private dermatology practice with the Standard Series of the International Contact Dermatitis Research Group (ICDRG). 454 of these were tested with one or more additional substances which were suspected of having caused their dermatitis. 194 of the 454 patients had positive reactions to one or more of the additional substances. Most of these reactions were of current relevance, and in only 25% of the patients could the allergies have been predicted by the use of the Standard Series alone. In approximately 50% of the patients, the reactions to additional substances could be traced to occupational sources.

Anti-Bacterial Agents↗
PubMedDate not supplied

Patch tests for diagnosis of delayed hypersensitivity to cephalosporins.

BACKGROUND: Few studies have reported delayed hypersensitivity reactions to systemically administered cephalosporins. The diagnostic procedures and extracts for these reactions are not standardized, and little is known about the extent of cross reactivity among different cephalosporins. CASES REPORT: We report 2 cases of delayed hypersensitivity reactions due to cephalosporins presenting as erythrodermia. Case 1. An 80-year-old man developed generalized pruritus and erythema 2-3 days after starting treatment with cefuroxime. The drug was stopped and antihistamines and corticosteroids were administered. The patient improved 5-6 days later, and mild superficial desquamation was observed. Case 2. A 66-year-old woman experienced similar symptoms 4-5 days after beginning cefazolin. She reported a similar reaction with ceftazidime 8 years previously. METHODS AND RESULTS: Skin prick tests and specific IgE against penicillin G and V, amoxicillin, ampicillin and cephalosporins were negative. Intradermal tests with ceftazidime and cefazolin were positive in case 2 at delayed reading. Patch tests using benzylpenicillin, ampicillin, amoxicillin, several cephalosporins, aztreonam and imipenem were positive to all the cephalosporins tested (at 48 and 96 hours) and were negative to the other betalactams. Controlled administration of amoxicillin, benzylpenicillin, aztreonam and imipenem was well tolerated by both patients. CONCLUSIONS: 1) We report 2 cases of delayed hypersensitivity reactions due to cephalosporins presenting as erythrodermia. 2) Epicutaneous tests were useful for diagnosis. 3) Both patients tested positive to all cephalosporins and negative to other betalactams.

Aged↗
PubMed2005

Atopy patch test reactions in high-IgE beagles to different sources and concentrations of house dust mites.

Protocols for atopy patch testing (APT) were evaluated on six high-IgE dogs sensitized to house dust mites (HDM) using various concentrations and sources of HDM. Two sources of HDM were compared: Heska slurry and four concentrations of Greer HDM. Saline was used as a negative control. Patches were removed after 48 h and the sites evaluated at 0, 6, 24, 48, 72 and 96 h for erythema, macules, papules and pustules. Each sign was scored from 0 to 3 (0 = absent and 3 = severe). Total score was used for analysis. Mean total scores significantly increased for both Greer and Heska HDMs from 6 h, peaking at 48 h for G100 (100 mg mL(-1)), G300 and G668, and at 72 h for Heska and G31.25. Across all times, Heska HDM scores were significantly higher than those of G31.25 with the largest difference at 96 h. Heska scores, however, were significantly lower than those of other Greer concentrations (G100, G300 and G668) particularly at 96 h. No reactions were noted at saline sites. It is concluded that Greer-HDM at 100 mg mL(-1) is the most suitable concentration for APT in dogs because it induces reactions comparable if not higher than more concentrated HDM preparations.

Allergens↗
PubMed2004

Atopy patch test with house dust mite allergen--an IgE-mediated reaction?

BACKGROUND: The eczema reaction in the atopy patch test (APT) is proposed to be immunoglobulin (Ig)E mediated, but can take place also in individuals lacking allergen-specific IgE in serum. The purpose of this study was to evaluate the importance of allergen-specific serum IgE for the APT reaction. METHODS: Ten patients with reproducible positive APT to extract of Dermatophagoides pteronyssinus, five patients with (group A) and five patients without (group B) detectable serum-IgE to D. pteronyssinus, were tested with extract of D. pteronyssinus on normal skin for 6, 24, 48 and 72 h. Skin biopsies were taken and analysed for cell infiltrates, eosinophils (EG2), IgE, FcepsilonRI, CD1a, CD4, CD8 and metalloproteinase 9 (MMP9). RESULTS: The number of IgE+, CD4+, EG2+ and MMP9+ cells increased with time in group A. FcepsilonRI+ cells and CD8+ cells increased with time in both groups. A correlation was found between the levels of D. pteronyssinus-specific serum-IgE and the score of dermal cell infiltrates at 72 h. The three patients with the highest values of allergen-specific IgE also had the highest expression of EG2+ cells and the highest APT scores. CONCLUSIONS: Our study strengthens the hypothesis that the IgE molecule has a key role, at least as an amplifier, in the APT reaction.

Adult↗
PubMed2005

Comparative assessment of the acute skin irritation potential of detergent formulations using a novel human 4-h patch test method.

Predictive skin irritation test methods, which do not require use of animals, are needed for the pre-market assessment of detergent formulations. The utility of a novel and ethical human acute skin irritation patch test method, originally developed for chemical skin irritation assessment, was evaluated. In this IRB-approved method, subjects were patched under occlusion for increasing periods of time up to 4h in duration. The total incidence of positive skin reactions for test products was compared to a positive control (20% aqueous sodium dodecyl sulfate [SDS]). Acutely irritating formulas were defined as those showing a significantly increased or equal incidence of positive responders compared with that of SDS. The time of exposure required for 50% of subjects to show a positive skin reaction (TR50 value) was calculated for each product and enabled test product comparisons within and between studies. Using this approach, 24 detergent formulations of various types were tested in seven individual studies. The skin irritation profiles were generally consistent within product types, which could be categorized as follows (by decreasing irritancy): mold/mildew removers (average TR50 = 0.37 h) > disinfectants/sanitizers (0.64 h) > fabric softener concentrate (1.09 h) = aluminum wash (1.20 h) > 20% SDS (1.81 h) > liquid laundry detergents (3.48 h) > liquid dish detergents (4.16 h) = liquid fabric softeners (4.56 h) = liquid hand soaps (4.58 h) = shampoos (5.40 h) = hard surface cleaners (6.34 h) > powder automatic dish detergents (>16 h) = powder laundry detergents (>16 h). In addition to formulation effects, some seasonal effects were noted; particularly greater winter-time reactivity to 20% SDS and the hard surface cleaner and liquid laundry formulations. These results demonstrate the utility of this patch test method for the comparative skin irritation assessment of these different product types.

Adult↗
PubMed1977

Patch testing with low molecular oligomers of epoxy resins in humans.

Thirty-four patients sensitive to epoxy resin were patch tested with oligomers of epoxy resin. All reacted when tested with MW 340 oligomer. Twenty-three were tested with MW 624 and MW 908 oligomers and seven with MW 1192 oligomer; none reacted. Eight patients tested with commercial mixtures of epoxy resins with an average MW 1280 and MW 1850 reacted to these resin mixtures which contained the MW 340 oligomer. The MW 340 oligomer seems to be the main ingredient responsible for contact allergy to epoxy resins in humans.

Allergens↗
PubMed1988

Ring-shaped positive allergic patch test reactions to allergens in liquid vehicles.

In recent years, we have observed several "ring-shaped" positive allergic patch test reactions to allergens dissolved in a liquid vehicle, a more intense response at the periphery of the site of application than in the central part. The occurrence of such reactions was evaluated for formaldehyde, Kathon CG, hydrocortisone and hexamidine diisethionate. Possible explanations for such reactions include pressure and/or a capillary effect.

Allergens↗
PubMed2002

The atopy patch test -- reproducibility and comparison of different evaluation methods.

BACKGROUND: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging. METHODS: Fifty-two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape-stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re-tested 4-12 weeks later with the same allergens on their forearms. RESULTS: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT-positive and negative volunteers was 19 +/- 6 vs 15 +/- 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallergènes, was poor. Correlation of the results between the three evaluation methods was significant (P < or = 0.001). CONCLUSIONS: The low reproducibility rate of APT results and the poor inter-test-agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.

Adolescent↗
PubMed1988

Results of routine patch testing of 542 patients in Saskatoon, Canada.

542 patients (330 women, 212 men) with suspected allergic contact dermatitis were patch tested to standard series allergens between January 1983 and June 1987. Positive reactions were most frequently seen with nickel (17.4%), ethylenediamine (8.7%), formaldehyde (7.4%), colophony (7.0%), potassium dichromate (6.1%) and neomycin (5.7%). Patients with dermatitis involving the legs were significantly more likely to be allergic to ethylenediamine (p = 0.01) and benzocaine (p = 0.04) than those with dermatitis not involving the legs. Neomycin allergy was not associated with dermatitis involving the legs. Patients allergic to ethylenediamine were significantly more likely to be allergic to neomycin than patients not allergic to ethylenediamine (p = 0.002).

Adolescent↗
PubMed2001

Comparison of urine to sweat patch test results in court ordered testing.

A former cocaine and methamphetamine abuser was continuously monitored with both sweat patch and urine testing for approximately 6 months. Thirteen sweat patches were applied and collected, five were positive for cocaine and/or methamphetamine, but all the urine specimens collected were negative at the analytical cut-off levels. The high incidence of false positive sweat patch tests in relation to the sensitivity, specificity, and efficiency of the sweat patch assay is discussed. Possible mechanisms, which can lead to false positive results, are presented. The results of our study raise further questions about the preferential use of the sweat patch in detecting new episodes of drug use in formerly chronic drug users.

Adult↗
PubMed1987

Quantification of patch test reactions by transcutaneous PO2 measurement.

The usefulness of transcutaneous oxygen tension (tc-PO2) measurement for quantification of positive patch test reactions was studied. A significant correlation was found between the visual grading and the quantitative tc-PO2 values. Tc-PO2 discriminated between visual grade 0 to 1+, 1+ to 2+, and 2+ to 3+ reactions. The results obtained by this method were compared with those obtained by other quantitative methods. Tc-PO2 measurement can be regarded as complementary to the laser Doppler technique, since it lacks the sensitivity of the laser Doppler technique in the range in negative to 1+ patch reactions, but it does discriminate between 2+ and stronger reactions.

Adult↗
PubMed1993

Time course of occlusive effects on skin evaluated by measurement of transepidermal water loss (TEWL). Including patch tests with sodium lauryl sulphate and water.

The time course for transepidermal water loss (TEWL) for a period of 3 h after removal of occlusive patch tests with sodium lauryl sulphate (SLS), water and empty chambers was studied in healthy volunteers. Patches were applied to the upper arm for 24 h. TEWL was measured immediately after removal of the patches, and every 30 min up to 3 h. For SLS and water patches, TEWL remained significantly increased for 3 h, as compared to normal adjacent skin, while for empty chamber patches, TEWL was only significantly increased for 30 min. A significant decrease from 0 to 30 min and from 30 to 60 min was observed for all patches, and for water patches, a significant decrease in TEWL was found from 60 to 180 min, while SLS patches remained constant. The prolonged increase in TEWL observed after SLS exposure is a well-known occurrence. The prolonged increase in TEWL after exposure to water is interpreted as transient damage to the water barrier of the skin.

Adult↗
PubMed1997

Reliability of a flushing questionnaire and the ethanol patch test in screening for inactive aldehyde dehydrogenase-2 and alcohol-related cancer risk.

Molecular epidemiology of esophageal and upper aerodigestive tract cancers revealed that alcohol is more carcinogenic in persons with inactive aldehyde dehydrogenase-2 (ALDH2) than in those with active ALDH2. A simple questionnaire has been developed to screen for the facial flushing that occurs in persons with inactive ALDH2 when they drink even a single glass of beer. In this study, 266 of 284 consecutive male Japanese clinic patients (age > or = 50 years) completed the flushing questionnaire, and 239 underwent the ethanol patch test (a cutaneous model for the flushing response). Blinded genotyping showed inactive ALDH2 for 94.4% (102 of 108) of subjects who reported always flushing (early in their drinking history or currently) and for 47.7% (21 of 44) of those who reported sometimes flushing, whereas 95.6% (109 of 114) of subjects reporting that they never exhibited facial flushing had active ALDH2. When all three categories of flushing (current always, former always, and sometimes) were collapsed into one, the questionnaire's sensitivity and specificity for identifying inactive ALDH2 were 96.1 and 79.0%, respectively, compared with 72.4 and 71.4% for the ethanol patch test. The results suggest the utility of this simple flushing questionnaire in daily practice, as well as large-scale studies to assess cancer risks associated with drinking and ALDH2 and for activities aimed at preventing alcohol-related cancer.

Aged↗
PubMed1989

Patch testing in prurigo nodularis.

32 patients with prurigo nodularis evaluated at the Mayo Clinic from 1975 to 1987 have been patch tested for sensitivity to appropriate allergen series; 25 of these had relevant positive reactions and subsequent follow-up to 5 to 14 years was available for 11. 6 patients had persistent disease and 5 had resolution or marked improvement. 3 of these latter patients noted a strong positive correlation between improvement and avoidance of contact allergens. Screening for contact sensitivity may be helpful in the management of this refractory dermatosis, particularly if there is a coexistent dermatitis.

Adrenal Cortex Hormones↗