scholarly journals Relevance of patch testing in patients of chronic spontaneous urticaria and its correlation with serum IgE level

2022 ◽  
Vol 1 ◽  
pp. 17-20
Author(s):  
Trupti Desale ◽  
Abhishek De ◽  
S. K. Shahriar Ahmed ◽  
Aarti Sarda ◽  
Kiran Godse ◽  
...  

Objectives: Chronic spontaneous urticaria (CSU) is defined as short lived (< 24h) wheals occurring spontaneously without any triggering factors, daily or almost daily for at least 6 weeks. Though CSU is mainly a Type 1 hypersensitivity reaction, earlier studies suggested contact allergy may have some role to play an important role in the etiopathogenesis of CSU. The objective of the study is to find out the relevance of patch test in the etiopathogenesis of and its correlation with serum IgE level. Materials and Methods: Thirty-one patients of CSU were thoroughly evaluated for clinical and laboratory parameters. We conducted patch testing with Indian Standard Series (ISS) in all of them and tried to find out the relevance of every positive reaction. Relevant positive cases were asked to avoid exposure for 2 months and were maintained only in breakthrough antihistamines. Furthermore, correlation of positive patch test reaction with high IgE and eosinophil count were studied. Results: Seventeen (55%) cases came positive for patch test. Potassium dichromate, lanolin, benzocaine, and fragrance mix were the most common offenders. Patients with very high IgE count had patch test positivity with multiple allergens. Seven of the fifteen patients who had relevant positive patch results could be followed up to remission; three were lost to follow-up. Conclusion: Patch test with ISS may give important clue to in a subset of patients of CSU and thus may be considered an important part of routine investigations of CSU.

2019 ◽  
Vol 7 (2) ◽  
pp. 204-207 ◽  
Author(s):  
Phuong Pham Thi Minh ◽  
Trang Thi Minh ◽  
Doanh Le Huu ◽  
Thuong Nguyen Van ◽  
Sau Nguyen Huu ◽  
...  

BACKGROUND: Hand eczema is a common chronic and relapsing skin disease with various clinical features. Hand eczema aetiology can be allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), atopic dermatitis (AD) and unknown or combination causes. If the causative agents are not detected treatment of hand eczema will be a failure. A patch test can be useful to detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema. In Vietnam, patch test has not been used before, so we conduct this study. AIM: To identify causative allergens by using patch test with 28 standard allergens in consecutive patients. METHODS: A group of 300 HE patients from the National Hospital of Dermatology and Venereology (NHDV) in Vietnam were enrolled in this study. They were divided into 4 groups-ACD, ICD, AD and unknown aetiology. The patient was patch tested with 28 standard allergens to identify the causative agents. RESULTS: Among the 300 HE enrolled patients, ACD accounted for 72.7%, AD and ICD had the same rate of 12.7%. 39.3% of the patients had a positive patch test. Reaction to nickel sulfate was the most common (10.3%), followed by potassium dichromate (9.7%), cobalt (4%) and fragrance mix (3.1%). About one-third of the cases had relevant clinical reactions correlated with the contact agents and clinical history. Males reacted to cement, thiuram mix and formaldehyde more than females, while females reacted to a nickel more than males. CONCLUSIONS: Hand eczema has variable clinical features and diverse aetiology. ACD is an important cause of hand eczema that can be managed with a patch test to detect causative allergens. Nearly 40% of HE cases had positive patch test. Relevant patch test reactions were seen in one-third of the patients. We propose using patch test detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema.


2019 ◽  
Author(s):  
Catriona I. Wootton ◽  
Mick Soukavong ◽  
Sonexai Kidoikhammouan ◽  
Bounthome Samountry ◽  
John S.C. English ◽  
...  

AbstractBackgroundDermatological services in Laos, South East Asia are limited to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population.ObjectivesThe aim of this study was to document common allergens in medical students in Laos. Patients/Materials/MethodsOne hundred and fifty medical students were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4.ResultsThirty-eight students (25.3%) had a positive reaction to at least one allergen, accounting for 52 reactions in total. The proportion of the students with positive patch test reading was significantly higher in the female [33/96 (34%)] than in the male [5/54 (9%)], p<0.001. The most common allergens were: nickel (10%), gold (6.6%), thiomersal (6.6%), cobalt dichloride (2%) and p-tert-Butylphenol formaldehyde resin (2%). Balsam of Peru (0.66%), black rubber mix (0.66%), Cl+Me-Isothiazolinone (0.66%), fragrance mix 1 (0.66%), quinolone mix (0.66%), methyldibromo glutaronitrile (0.66%), mercapto mix (0.66%), epoxy resin (0.66%), paraben mix (0.66%), thiuram (0.66%) and wool alcohols (0.66%) accounted for all of the other positive reactions.ConclusionThis study represents the first documented patch test results in Lao medical students and in the adult Lao population. The results of this study will inform any future research into contact allergy in Laos and give an insight into the background level of contact sensitivity in this population.


Medicina ◽  
2011 ◽  
Vol 47 (9) ◽  
pp. 480 ◽  
Author(s):  
Aistė Beliauskienė ◽  
Skaidra Valiukevičienė ◽  
Brigita Šitkauskienė ◽  
Axel Schnuch ◽  
Wolfgang Uter

Background and Objective. The pattern of contact sensitization among patients with chronic leg ulcers depends on the local practice of wound treatment along with demographic and clinical confounders. The study was aimed at revealing the associations between chronic leg ulcers and contact sensitization. Material and Methods. Between 2006 and 2008, 35 patients with chronic leg ulcers and surrounding dermatitis and 59 patients with contact dermatitis of the lower leg or foot were prospectively recruited at the Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences. Demographic and clinical data were collected in accordance with the “minimal data set” of the European Surveillance System on Contact Allergy. Patch testing was performed with the allergens of the European baseline series. Results. At least one positive patch test reaction was found in 28 (80%) of the patients with chronic leg ulcers and in 24 (41%) of the patients with dermatitis of the lower leg or foot (P<0.001). Sensitization to some of the most common allergens, namely colophony, Myroxylon pereirae resin, and methyldibromo glutaronitrile, was prevalent in both the groups of patients, whereas sensitization to benzocaine, p-phenylenediamine, and lanolin alcohol was associated with the presence of chronic leg ulcers. Benzocaine was found to be the leading allergen among patients with chronic leg ulcers (positive patch test reactions in 34.4% of the patients). Conclusions. Contact sensitization to benzocaine, p-phenylenediamine, and lanolin was found to be associated with the presence of chronic leg ulcers.


2019 ◽  
Vol 70 (4) ◽  
pp. 1337-2341 ◽  
Author(s):  
Maria-Magdalena Constantin ◽  
Stefana Bucur ◽  
Clara Matei ◽  
Iuliana Elena Nita ◽  
Traian Constantin

In Romania, data on patch testing are lacking and the significance and applicability of the European baseline series (EBS) needs to be evaluated. The aim of the study was to examine the prevalence of contact allergy to the EBS and to determine the most common post-test sensitization occurred in the population of patients with suspected allergic contact dermatitis in Romania. Demographic data were collected from 252 patients with suspected allergic contact dermatitis. Pacients were patch tested with 28-allergen EBS.The positive patch test was observed in 80.16% patients. The most prevalent contact allergens were nickel sulphate (15.08%), fragrance mix I & II (13.10%) and potassium dichromate (9.52%). Differences in sensitization prevalences to some allergens of the EBS compared with other European countries were recognized. The current EBS is a suitable diagnostic tool for contact allergy in Romania.


2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Thacharamban Mansoorali ◽  
Abdulsalam Sarin

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.


Author(s):  
S. Jyothi Lakshmi ◽  
K. Gopalakrishnan

<p class="abstract"><strong>Background:</strong> Hand eczema is a common dermatological problem resulting from both allergic and irritant contactants. Patch testing helps in both diagnosing and identifying allergens.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study wherein 110 patients with hand eczema attending Dermatology OPD were included and patch testing was done. Data was collected from April 2015 to July 2016 and was analysed for clinical and epidemiological characteristics.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients studied was 40.27 years with male preponderance. Housewives were the major occupational group comprising 25.5% followed by masons 21.8% and farmers 10.9%. The commonest morphological type was hyperkeratotic type constituting 51.85%, followed by fingertip eczema 19.1%, discoid eczema 11.8%, wear and tear dermatitis 8.2%, recurrent focal palmar peeling 4.5% and pompholyx 4.5%. In the study group 60% of patients showed positive patch test result. A total 66 patients showed patch test positivity to a total of 69 allergens. Nickel was the most common allergen 27.3% identified followed by potassium dichromate 10.9%. Among female patients with positive patch test 70% reacted to nickel and similarly 83.5% of male patients reacted to potassium dichromate. Parthenium allergy was seen in 41.5% of farmers studied.</p><p class="abstract"><strong>Conclusions:</strong> Patch testing has a definitive role in diagnosing hand eczema caused by allergens. Identifying the allergen involved helps the clinician in advising the patient regarding further avoidance of contactants.</p>


Author(s):  
Shyni Perumbil ◽  
Kunnummal Muhammed ◽  
Sarita Sasidharan Pillai

<p class="abstract"><strong>Background:</strong> Juvenile plantar dermatosis (JPD) is characterized by shiny dry fissured dermatitis of the plantar surface of the foot, affecting children aged 3-14years. The most accepted theory is that JPD is a frictional contact dermatitis of the forefoot in which atopics are more prone to develop. Allergic contact dermatitis remains a close differential diagnosis; it can aggravate the predisposing JPD. In this background we carried out a study among children aged fourteen years and below with clinically diagnosed JPD to know the age and sex profile, aggravating factors and clinical features in this part of the country<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> All children aged 14 years and below with JPD attending our outpatient department from November 2006 to November 2007 were included in this study. Using a preset proforma, data regarding age and sex, information on any relation to footwear, past history of allergic disorders in person or family members was collected. All the 40 patients were patch tested using the footwear allergen series in petrolatum base. Patch test unit was removed after 48hours and the results were interpreted using criteria laid down by International Contact Dermatitis Group (ICDRG). The data was analyzed and made an attempt to understand the role of footwear allergy in JPD.</p><p class="abstract"><strong>Results:</strong> 22 girls and 18 boys attended our OPD with JPD between the age group of 4-14 years. 52.5% were using footwear made of plastic; 25%used leather; 12.5% rubber footwear. Patients presented with erythema and glazed appearance of foot along with fissuring. The areas of involvement were distal soles and toes in 70%, distal sole alone in 7.5% and distal sole and dorsum of toes in 22.5% of patients. Personal history of atopy was documented in 15% of patients and family history of atopy was present in 20% of cases. 20% of patients complained of exacerbation with footwear. Of the 40 patients who underwent patch testing, 10% only showed <span lang="EN-IN">positive patch test reaction mainly to potassium dichromate (5%). </span></p><p class="abstract"><strong>Conclusions:</strong> JPD is not an uncommon disease and it predominantly affects school going children. Seasonal variation was associated with aggravation of disease. Specific footwear was identified to cause flare ups in a significant percentage of study population (20%) and this was proven by patch test results in half of them. Though nearly one fifth of the affected had an atopic diathesis in person or family, the present data suggests that JPD is not exclusive to atopics. A large sized study is required to <span lang="EN-IN">evaluate the role of footwear in JPD.</span></p>


2021 ◽  
pp. 20-22
Author(s):  
SivaKumar Sivasubramaniam ◽  
Ambujam Govindasamy ◽  
Kode Leela Sravanthi ◽  
Brindha Pandiyan

Introduction: Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on day-to-day basis. Patch testing is a reliable method for detecting the causative antigens in suspected cases. Aims And Objectives: To assess the demographic profile, pattern of ACD, and patch test profile of suspected cases of ACD attending contact dermatitis clinic of our department. Materials And Methods: It was a prospective study in which all the patients with suspected ACD attending OPD of department of dermatology over a 3 month period were analysed. Patch testing was done using the most common antigens primarily, and other batteries were used depending on patient requirement and availability. Results: A total of 50 patients were enrolled in the contact dermatitis clinic over a period of 3 months. Hand eczema was the most common pattern seen in 23 cases followed by feet eczema, hand and foot eczema, facial eczema, forearm and leg eczema and photoallergic contact eczema. A total of 32 (64%) gave positive patch test results, with nickel sulfate being the most common allergen identified followed by cobalt sulfate & potassium dichromate. Conclusion: Common allergens identified in our study were more or less similar to studies from other parts of India


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