Patch testing in allergic contact dermatitis

AbstractA deterioration in chronic inflammatory ear disease despite topical medication, or failure of the condition to improve with such treatment, should raise the possibility of allergic contact dermatitis. Allergen testing (patch testing) is the ‘gold standard’ method of identifying an agent causing allergic contact dermatitis.We describe an ENT patch test series applied by our department as a screening device for this condition.

Download Full-text

Polysensitization in Recurrent Lip Dermatitis

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2014.13215 ◽

2015 ◽

Vol 19 (1) ◽

pp. 77-80 ◽

Cited By ~ 1

Author(s):

Kathleen Fraser ◽

Melanie Pratt

Keyword(s):

Case Report ◽

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Test ◽

Patch Testing ◽

Clinical Relevance ◽

Positive Patch Test ◽

Test Reactions ◽

Allergic Contact

Background: In allergic contact dermatitis (ACD), polysensitization consists of positive patch test reactions to three or more unrelated allergens. Objective: The purpose of this case report is to document a 27-year-old female with recurrent lip dermatitis, polysensitization, and reactions to a number of clinically relevant exposures. Methods: Patch testing results revealed positive reactions to tixocortol-21-pivalate (3+), lanolin (3+), neomycin (3+), nickel (1+), hydroxyethyl methylacrylate (3+), bacitracin (3+), and abitol (3+). Results: The patient had seven positive reactions, meeting the criteria for polysensitization. Of known clinical relevance, the patient had applied lanolin-containing lip balms and hydrocortisone- and bacitracin-containing products to the lips, all of which she was strongly reactive to on patch testing. Conclusion: Polysensitization occurs when three or more unrelated allergens are positive on patch testing. This case highlights the importance of considering polysensitization in ACD as numerous allergens that were positive on patch testing were clinically relevant.

Download Full-text

Common Contact Sensitizers among Patients with Hand Eczema: A Multicenter-Study in Nepal

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v14i1.15809 ◽

2016 ◽

Vol 14 (1) ◽

pp. 14-17

Author(s):

S. Bhattarai ◽

A. Rijal ◽

S. Agrawal

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Test ◽

Patch Testing ◽

Potassium Dichromate ◽

College Teaching ◽

Hand Eczema ◽

Contact Allergens ◽

Allergic Contact

Introduction: Allergic contact dermatitis in Nepal is not an uncommon disorder. Patch testing is a well established method of diagnosing allergic contact dermatitis. Patients with contact dermatitis are well known to have impaired quality of life which often leads to frequent dermatological consultations.Objective: Lack of data from Nepal has prompted us to undertake this study with the aims to know the frequency of allergic contact dermatitis and the commonest contact allergens among the patients with Hand eczema attending the out-patient department of dermatology, B.P. Koirala Institute of Health Sciences and Kathmandu Medical College Teaching Hospital.Material and Methods: A total of 256 patients were included in the study. Out of them 195 with hand eczema agreed to participate and undergo patch testing. The antigens used included the Indian standard series of patch test allergens approved by Contact and Occupational Dermatoses Forum of India.Results: Hundred and ten cases (56.4%) were patch test positive (PTP) at 48 as well as 96 hours to at least one allergen. PTP was seen more commonly in females. The most common allergen in females was nickel sulphate followed by cobalt chloride, gentamicin and mercapto mix while males were positive to potassium dichromate, followed by epoxy resin, fragrance mix and nickel sulphate.Conclusion: Patch testing has proved a useful tool for the detection of allergic contact dermatitis and for identification of contact allergens. When positive reactions correlate with environmental exposure the test usually assists the physician in establishing the cause of dermatitis, hence treating the patients and improving their quality of life.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.14-17

Download Full-text

Results of patch tests (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis to cement: A cross-sectional study

Journal of Skin and Sexually Transmitted Diseases ◽

10.25259/jsstd_60_2021 ◽

2021 ◽

Vol 0 ◽

pp. 1-5

Author(s):

Thacharamban Mansoorali ◽

Abdulsalam Sarin

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Test ◽

Positive Reaction ◽

Patch Testing ◽

Tertiary Referral ◽

Test Reaction ◽

Tertiary Referral Center ◽

Positive Patch Test ◽

Allergic Contact

Objectives: The objective of the study was to identify the allergens showing positive patch test reaction (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis (CD) to cement attending a tertiary referral center. Materials and Methods: We included cement workers with clinically diagnosed allergic CD to cement who attended the dermatology outpatient clinic of our tertiary referral center from January 2013 to December 2013. We did patch testing in all the cases ( after subsidence of active dermatitis) with Indian standard battery of patch test allergens and documented the allergens that showed a positive reaction. Results: Forty-seven (94%) of the 50 study participants showed a positive reaction to one or more of the allergens. The most common allergen that showed a positive reaction was potassium dichromate (43/50, 86%). Twenty-five patients (50%) showed positive reactions to more than 1 allergen. Four patients (8%) showed positive reactions only to allergens that were not seen in cement. Limitations: Small sample size and lack of information on clinical response of dermatitis to avoidance of identified allergen were the major limitations. Conclusion: Twenty-five (50%) patients showing positive reactions to more than 1 allergen tested and 4 (8%) showing positive patch test reaction to none of the allergens in cement (but to other allergens) highlight the role of patch testing in identifying the probable allergens in patients with clinically diagnosed allergic CD to cement.

Download Full-text

A study on incidence of various allergens involved in allergic contact dermatitis by patch testing among 150 patients in a tertiary care hospital in South India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20181820 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205

Author(s):

V. N. S. Ahamed Shariff ◽

K. Deepa ◽

L. Balamurugan ◽

S. Nirmala

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Test ◽

Patch Testing ◽

Potassium Dichromate ◽

Tertiary Care ◽

Care Hospital ◽

Female Ratio ◽

Allergic Contact ◽

Male To Female

Background: Allergic contact dermatitis is common dermatoses seen among patients attending dermatology clinics. Allergic contact dermatitis is due to delayed type of hypersensitivity reaction. The diagnosis of allergic contact dermatitis is made by patch testing. A positive reaction to a patch test commonly proves the cause of dermatitis.Methods: A retrospective study was conducted to estimate the incidence of various allergens among 150 patch test positive patients with allergic contact dermatitis who had attended the dermatology OPD in Rajiv Gandhi Government General Hospital, Chennai, between October 2014 and September 2016. All the details regarding history, examination findings, investigations and patch test results were collected from case records, the data were tabulated and analysed.Results: Allergic contact dermatitis to cement was the commonest (44.7%), followed by nickel (10%) and plant antigens (9.3%). The commonest allergen to be tested positive was Potassium dichromate (82 cases), followed nickel (15 cases) and formaldehyde (8 cases). Most of the patients were in the age category between 41 and 50 years (47 cases– 31.33%). Male to female ratio was 2.41:1. 14 were atopic individuals (9.33%) by Hanifin and Rajka's criteria. Allergic contact dermatitis in 103 cases of our study were of occupational in origin (67%).Conclusions: Avoidance of allergen and proper preventive measures in workplace and day to day activities will lead to significant decrease in the morbidity of the disease and improvement in quality of life in patients with allergic contact dermatitis.

Download Full-text

Cytokine detection for the diagnosis of chromium allergy

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20132164 ◽

2013 ◽

Vol 88 (5) ◽

pp. 719-725 ◽

Cited By ~ 4

Author(s):

Luis Eduardo Agner Machado Martins ◽

Vitor Manoel Silva dos Reis

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Testing ◽

Etiologic Agent ◽

Subjective Time ◽

Nickel Allergy ◽

Gold Standard Method ◽

Cytokine Detection ◽

Sensitivity Specificity ◽

Allergic Contact

BACKGROUND: Patch testing remains the gold standard method for the identification of the etiologic agent of allergic contact dermatitis. However, it is a subjective, time-consuming exam whose technique demands special care and which presents some contraindications, which hamper its use. In a recent study, we showed that the proliferation assay can suitably replace patch testing for the diagnosis of chromium allergy, which had been previously demonstrated only for nickel allergy. In this study, we try to refine the method by reducing the incubation period of cultures for lymphocyte proliferation assays in response to chromium. OBJECTIVE: Develop an alternative or complementary diagnostic test for chromium allergic contact dermatitis. METHODS: We compared the production of 9 cytokines (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and RANTES) between 18 chromium-allergic patients and 19 controls. RESULTS: Chromium increased the production of IFN-y, IL-5, IL-2 and IL-13 in allergic patients, but only IL-2 and especially IL-13 helped discriminate allergic patients from controls. The sensitivity, specificity and accuracy found with IL-13 were about 80%. CONCLUSIONS: IL-13 and IL-2 detection may be used to diagnose chromium allergy in 2-day cultures. However, in general, the 6-day cultures seem to be superior for this purpose.

Download Full-text

Study of Common Allergens in Patients with Allergic Contact Dermatitis: A Hospital Based Study

Nepal Medical College Journal ◽

10.3126/nmcj.v23i1.36222 ◽

2021 ◽

Vol 23 (1) ◽

pp. 16-22

Author(s):

Arnija Rana ◽

S Shrestha ◽

AK Jha ◽

DP Thapa ◽

S Joshi ◽

...

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Test ◽

Patch Testing ◽

Potassium Dichromate ◽

Nickel Sulphate ◽

Dermatology Department ◽

Positive Patch Test ◽

Number Of Patients ◽

Allergic Contact

Allergic contact dermatitis (ACD) is one of the most common diseases presenting to the Dermatology department. The one and only method of preventing as well as treating this disease is avoidance of the allergen causing it. The identification of the allergen causing the ACD is possible by performing patch testing. The purpose of this study was to identify common allergens among patients with ACD using Indian standard series (ISS) of patch test. Clinically suspected cases of ACD were included in the hospital based cross-sectional study from January to December 2017. These cases underwent patch testing with the ISS. The study assessed the following variables: sex, age, occupation, site and positive patch test results. There were a total of 58 patients among which, 36.2% were males and 63.8% were females with a mean age of 32.36±12.51 years. Positive patch test reactions were seen in 63.0% of patients. The most common allergens were nickel sulphate (51.4%), fragrance mix (37.8%), potassium dichromate (8.1%), colophony (8.1%) and black rubber mix (8.1%). Among male, most common allergens were fragrance mix (57.1%), nickel sulphate (28.6%) and potassium dichromate (21.4%) while in female, most common allergens were nickel sulphate (65.2%) and fragrance mix (26.1%). In our study, majority of the allergens were positive. Hence, the ISS used in the study might be suitable in the context of Nepalese population. However, further similar studies on large number of patients with multiple allergens are required to determine the exact number of contact allergens prevalent in our population.

Download Full-text