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At least 811 records · Page 45Linked to original sources
PubMed1995

Oral lichenoid lesions, mercury hypersensitivity and combined hypersensitivity to mercury and other metals: histologically-proven reproduction of the reaction by patch testing with metal salts.

We report 11 patients seen between 1991 and 1994 with oral lichenoid lesions (OLL). In 10 cases, there was contact with dental amalgam fillings, and in patient no. 10 with both amalgam restorations and a gold crown. The last patient had, in addition to her OLL, lichen planus of the skin and genital mucosa. In 5 cases, combined sensitization to mercury and other metal salts, particularly gold sodium thiosulfate (GST) and palladium chloride (PDC), was observed. In 10 patients, the lesions considerably improved or totally cleared within 1 to 9 months of replacement of restoration materials. Histological examination of biopsies from the test sites of amalgam, mercuric chloride, GST and PDC, taken 10 or 17 days after application of patch tests, showed lichenoid changes in 7 patients with at least 1 of the allergens. As at least 2 patients had inflammatory lesions of the oral mucosa related to both amalgam and gold restorations, combined sensitization to inorganic and organic mercury derivatives, GST and, in 1 case, PDC, a "dental restoration metal intolerance syndrome" is proposed.

Adult↗
PubMed2006

Modulation of atopy patch test and skin prick test by pretreatment with 1% pimecrolimus cream.

BACKGROUND: In a subgroup of patients with atopic eczema (AE), aeroallergens are relevant eliciting factors. The atopy patch test (APT) was proposed as inflammation model for AE. OBJECTIVE: It was the aim of this study to investigate the effect of pretreatment with 1% pimecrolimus cream (Elidel) on the APT and skin prick test (SPT). METHODS: In a randomized, controlled, double-blind study, 20 patients with AE and positive SPT and APT screening reaction to house dust mite Dermatophagoides pteronyssinus, cat dander, grass or birch pollen were enrolled (age 20 +/- 11 years, 55% males). For 2 weeks, patients twice daily applied pimecrolimus and vehicle control to marked fields on their backs and forearms. Then, APT was performed (200 index of reactivity/g extracts in petrolatum; Stallergènes, France) on both fields on the back and SPT was performed on the pretreated forearms. RESULTS: Including only patients with different readings (n = 13), stronger APT suppression of at least 1 ETFAD (European Task Force on Atopic Dermatitis) grade in the pimecrolimus area versus intraindividual control was observed in 10 of these patients after 48 and 72 h (p < 0.05; 90% CI 50.5-93.4). Including all 20 subjects, the analysis still showed a borderline significance compared with the vehicle (p = 0.0564). SPT with histamine and aeroallergens showed a median 7.5-10% reduction in actively pretreated areas (p = 0.086). Immunohistochemical analysis in 2 patients revealed an induction of interferon-gamma in primecrolimus-pretreated skin. CONCLUSION: APT can be used as a model for AE skin inflammation. It was shown for the first time that pimecrolimus pretreatment has a potential to suppress the development of lesions induced by aeroallergen exposure in patients with AE.

Adult↗
PubMed1984

A diagnostic "patch test" for onchocerciasis using topical diethylcarbamazine.

There is great need for a simple, inexpensive, and sensitive diagnostic test for onchocerciasis, especially in endemic areas where trained personnel and laboratory facilities are limited. Diethylcarbamazine (DEC) was applied as a "patch test" to the skin of 45 patients with onchocerciasis in the Southern Sudan. 75 tests were done on these 45 patients, and 69 (92%) were positive. A positive reaction was a papular eruption beneath the patch. Histopathological studies of the skin beneath the patch revealed the microscopic features of a severe Mazzotti reaction, including degenerating microfilariae in the upper dermis and within epidermal eosinophilic abscesses.

Administration, Topical↗
PubMed2005

Ciprofloxacin-induced acute generalized exanthematous pustulosis mimicking bullous drug eruption confirmed by a positive patch test.

We report the case of an 80-year-old woman presenting with ciprofloxacin-induced acute generalized exanthematous pustulosis (AGEP) confirmed by a positive patch test. Cutaneous morphology, course and histological findings were consistent with a definite diagnosis according to the AGEP validation score of the EuroSCAR study group. We point to the rarity of quinolone-induced AGEP and discuss immunological mechanisms, the value of in vivo and in vitro tests as well as the main differential diagnosis. Furthermore, we highlight in this particular case the challenging differentiation from bullous drug eruption.

Aged, 80 and over↗
PubMed1994

Should atopic individuals be patch tested?

Although it appears that the incidence of allergic contact dermatitis is lower in patients with atopic dermatitis than in patients with other forms of dermatitis, studies have shown that a significant number of atopics demonstrate allergic contact dermatitis on testing. This article presents a review of the larger studies that have been performed in atopic individuals as well as recommendations for patch testing.

Adult↗
PubMedDate not supplied

Frequency and relevance of positive patch tests to cyclohexylthiophthalimide, a new rubber allergen.

Cyclohexylthiophtalimide (CTP) is currently the most widely used vulcanization retarder in the rubber industry. Little is known about sensitization to CTP, although positive tests to it do occur in patients exposed to rubber objects. A retrospective study of 350 patients who were patch tested with the standard rubber chemical series was conducted in two departments of dermatology, one in Nancy, France, and one in Leuven, Belgium. Sixteen (4.6%) out of the 350 patients had clear and 6 (1.7%) had doubtful positive reactions to CTP. Cross-sensitivity with other molecules could not be determined. The source of sensitization in most cases seems to have been protective rubber gloves at work. In the other cases, sensitization was suspected to have been caused by rubber shoes, elastic bands in underwear, or other rubber objects. The determination of the relevance of positive tests remains difficult, especially since little is known about the components of rubber products.

Adult↗
PubMedDate not supplied

Patch testing for occupational allergens and the evaluation of patients with occupational contact dermatitis.

With the expanding interest in the environmental causes of disease, carefully performed, differential patch testing in suspected cases of contact allergy becomes a vitally important part of the investigation. Although all of the necessary allergens have not yet been released by the FDA for U.S. manufacture and distribution, it is hoped this will occur within the next few months. The thousands of patients with work-related allergic contact dermatitis can then hope for to learn the exact source of their disease, which can then lead to suitable work adjustments.

Allergens↗
PubMed1992

Combination of patch test and IgE for dust mite antigens differentiates 130 patients with atopic dermatitis into four groups.

BACKGROUND: Patients with atopic dermatitis sometimes have positive responses to patch testing (PT) with dust mite antigens, which is believed to correlate with the elevated levels of specific IgE for those antigens. OBJECTIVE: The purpose of this study is to identify the correlation between the PT and serum IgE concerning the mite antigens. METHODS: We studied 130 patients with atopic dermatitis by the PT reaction and the serum level of specific IgE for Dermatophagoides pteronyssinus antigens. RESULTS: Fifty-one of the 130 patients assessed as PT-positive had either high (32 of 130 patients; 24.6%) or low or no (19 of 130 patients; 14.6%) levels of mite-specific IgE; there was a significant difference between the groups with elevated and low IgE. Similarly, a total of 79 PT-negative patients also showed an elevated or low mite-specific IgE (42 of 130 patients [32.3%] or 37 of 130 patients [28.5%], respectively). It was noted that clinical morphologic findings were peculiar to three of the four groups; however, the patients who were PT-negative with a low IgE (37 of 130 patients) showed no particular clinical lesions. CONCLUSION: Comparing the results from our 130 patients, there was no correlation between the serum IgE level and the PT reaction for dust mite antigens. Conversely, the results of PT and mite-specific IgE could be used to divide these patients into four distinct groups, each with its own particular clinical morphology, suggesting the heterogeneity of this disease.

Adolescent↗
PubMed2002

The utility of patch testing children with atopic dermatitis.

Allergic contact dermatitis (ACD) is more frequent in the pediatric population and in children with atopic dermatitis (AD) than has hitherto been appreciated. Patch testing, which is mediated by different immune mechanisms than prick skin testing, is both safe and diagnostically useful for individuals with AD. It may help to identify exacerbating allergies, e.g., constituents of topical treatments in refractory AD and to formulate treatment plans that feature preventive avoidance of the offending allergens.

Dermatitis, Allergic Contact↗
PubMed2002

[Skin patch test with nickel sulphate--an attempt of broader interpretation of the results].

Skin patch test with nickel sulphate provides grounds for distinguishing 10% females with hypersensitivity to ions of this metal. The literature data published as yet indicate that in these women an alteration takes place in conditions of the inner environment of their organisms. The alteration may result in an absence of adaptive capacities of the women to altered conditions of the outer environment (occasional, transient elevation in nickel ion level in the environment). Such an approach to the problem opens discussion on the accepted as yet, egocentric pattern of thinking, related to effects of metal ions on the organism and described as the physiological mechanism of the type I and IV hypersensitivity. The author suggests that nickel ions, acting at subtoxic levels but markedly exceeding the doses defined as physiological ones, which may develop locally, transiently in the outer environment, may exert unfavourable effects on, depending upon the level of conducted studies, molecular, cellular, tissue or body levels. The absence of skin adaptive capacity to, i.a., neutralize the excess of ions at the site of their application disturbs in a dose-related manner the normally functioning immune system, what is manifested with an inflammatory reaction of various intensity.

Dermatitis, Allergic Contact↗
PubMed1985

Patch tests in Sézary syndrome and mycosis fungoides.

A retrospective series of 34 patients with the diagnoses of Sézary syndrome, pre-Sézary syndrome, or mycosis fungoides had had patch testing. Of these, 27 had at least 1 positive reaction (11 of 12 with pre-Sézary syndrome, 6 of 10 with Sézary syndrome, and 10 of 12 with mycosis fungoides). The highest average number of positive reactions was observed in patients with pre-Sézary syndrome (4.7 per patient). There was no predominance of positive reactions to any one allergen, but 13 of the 27 patients reacted to a metal allergen. Only 1 of 5 patients who had photopatch testing had a positive result. This retrospective study revealed delayed contact hypersensitivity responses in this group of patients and should serve as a basis for prospective consideration of contact dermatitis factors in patients with mycosis fungoides and Sézary states.

Allergens↗
PubMedDate not supplied

[Computer-assisted recording and processing of patch test data. A model].

In the Department of Dermatology of the University of Graz (Austria) since 1985 an electronic data system is used for registration and evaluation of patch test data. The installed system (hardware and software), database and the possible methods for evaluation are presented. The necessity of global solution of the problem with possible access to complete database (patient data, product declaration and literature) is emphasized.

Computers↗
PubMed1995

Positivity of patch tests in cutaneous reaction to aminocaproic acid: two case reports.

We observed two cases of maculopapular eruption occurring 12-72 h after the administration of aminocaproic acid (ACA). Patch tests performed with ACA were positive. Clinical and allergologic patterns suggest the type IV mechanism of hypersensitivity. We present what we believe are the first two cases described of hypersensitivity to this drug.

Adolescent↗
PubMed1982

Basophils in allergen-induced patch test sites in atopic dermatitis.

Atopic dermatitis often occurs in patients who have high IgE levels and positive immediate skin tests to several common allergens. However, there is considerable doubt about the role played by allergens in this disease. Patch testing for 48 h at superficially abraded skin sites revealed that allergens could induce eczematous lesions in atopic dermatitis patients but only in those who also gave a positive immediate skin reaction to the same allergen. Lesions induced by the purified house dust mite antigen, antigen P1 contained mononuclear cells, basophils, eosinophils, and neutrophils. These patients also had raised specific serum IgE against antigen P1, and their leucocytes released histamine upon exposure to the same antigen. Thus an acute eczematous lesion can be induced by the application of inhalant allergens to the skin.

Adolescent↗
PubMed2002

Cutaneous lidocaine allergy confirmed by patch testing.

A case is presented of a 55-year old woman who developed an eruption suggestive of contact dermatitis on repeated occasions after receiving anesthesia for dermatologic procedures. Patch testing revealed a positive reaction to lidocaine. Basic structures of anesthetics are reviewed, and the classification of immunologically-mediated allergic reactions is discussed. The presence of cutaneous lidocaine allergy has profound implications for the field of dermatology.

Anesthetics, Local↗
PubMed1994

Identification of causative chemicals of allergic contact dermatitis using a combination of patch testing in patients and chemical analysis. Application to cases from rubber footwear.

5 cases of allergic contact dermatitis from rubber footwear were investigated by a combination of patch testing in patients and chemical analysis of causative rubber products. Our studies revealed 2-mercaptobenzothiazole (MBT) and benzothiazyl disulfide (MBTS) (typical allergenic accelerators) as causative chemicals in 3 cases from children's rubber shoes, ladies' rubber boots and ladies' canvas shoes. These 3 patients reacted to mercaptobenzothiazole-type accelerators including MBT and MBTS. MBT and MBTS were determined in each item of causative footwear by chemical analysis, including extraction by shaking with acetone-chloroform (1:1) mixture at room temperature and determination using reversed-phase high-performance liquid chromatography (RP-HPLC). Subsequently, we identified styrenated phenol (SP), a newly found allergenic antioxidant, as a causative chemical in a case from ladies' canvas shoes. The patient reacted to SP but not to MBT and MBTS, though SP, MBT and MBTS were determined in the causative shoes by gas chromatography (GC), GC-mass spectrometry (GC-MS) and HPLC. We also identified p-tert-butylphenol-formaldehyde resin (PTBP-F-R), (a known allergenic adhesive ingredient) as a causative chemical in a case from ladies' sneakers. The patient reacted to PTBP-F-R but not to p-tert-butylphenol (PTBP), MBT and MBTS. These 4 compounds were determined in the causative sneakers by GC, GC-MS and HPLC. Thus, our studies revealed that not only known allergens, such as MBT, MBTS and PTBP-F-R, but also a newly found one, such as SP, were important causes of allergic contact dermatitis from rubber footwear.

Adhesives↗
PubMed2004

The diagnostic accuracy of the atopy patch test in diagnosing hypersensitivity to cow's milk and hen's egg in unselected children with and without atopic dermatitis.

BACKGROUND: Previous studies have suggested that the atopy patch test (APT) may make oral challenge superfluous in diagnosing children with food hypersensitivity. OBJECTIVE: To investigate the clinical relevance of APT in predicting hypersensitivity to cow's milk and hen's egg in 486 unselected children 3 years of age. METHOD: The children were examined by APT, skin prick (SPT), histamine release (HR), and specific IgE followed by oral challenge when hypersensitivity to cow's milk or hen's egg was suspected. RESULTS: Food hypersensitivity confirmed by oral challenge was 1.6% to hen's egg and 0.6% to cow's milk. No hypersensitivity to cow's milk or hen's egg was predicted by APT alone. CONCLUSION: APT could not predict food hypersensitivity not predicted by SPT, HR, or specific IgE. Thus, APT cannot be recommended in daily practice for the diagnosis of hypersensitivity to cow's milk and hen's egg in children 3 years of age.

Basophils↗