Role Of Patch Testing Research Articles

Role of Patch Testing in Facial Contact Dermatitis: A Cross-Sectional Study from Central India.

Facial contact dermatitis is an emerging skin disorder due to the use of a large array of materials over the face. It leads to psychological distress in patients, impacting their quality of life. Most of the allergens applied over the face vary as per cosmetic or herbal products' availability, usage, or religious practices. Identifying and discontinuing the implicated allergens will lead to a better prognosis and reduced morbidity in clinical practice. To determine the frequency of different allergens responsible for causing facial contact dermatitis, in an urban part of central India, using patch test with the help of Indian standard and cosmetic series. All suspected patients (>18 years) of facial contact dermatitis visiting the outpatient department of dermatology were patch tested with both Indian standard and cosmetic series. Out of 38/58 patch-test-positive patients, 71.06% were females, and 28.94% were males. Most patch-test-positive females were housewives. The most common allergens implicated were thiomersal (17.24%), followed by fragrance mix (15.51%), and paraphenylene diamine (12.06%). In our study, forehead and malar areas were most commonly involved indicating fairness creams and perfumes as the important contributors to facial contact dermatitis. Antigen batteries need to be updated with changing social and cultural trends, as many with a consistent history of aggravation with some products tested negative in patch tests.

CD11 Patch testing in vulval dermatoses

Abstract Patch testing is an important tool in the investigation of patients with vulval dermatoses, with a significant impact on patients with a relevant identifiable allergen. There has been little research conducted in this area, with small studies suggesting a higher rate of positivity in anogenital dermatoses (39–78%) vs. patch testing in female patients generally (35–40%) (Woodruff CM, Trivedi MK, Botto N, Kornik R. Allergic contact dermatitis of the vulva. Dermatitis 2018; 29:233–43). There is also a high rate of clinically relevant results (13–49%) (Vandeweege S, Debaene B, Lapeere H, Verstraelen H. A systematic review of allergic and irritative contact dermatitis of the vulva: the most important allergens/irritants and the role of patch testing. Contact Dermatitis 2023; 88:249–62). The aetiology of this increased rate of allergic dermatitis at this site can be attributed to a number of factors. This includes intrinsic immunological characteristics of the vulval skin, local elements including infection and urine exposure, as well as external behavioural factors. There is a lack of site-specific guidance in light of this propensity of allergic contact dermatitis in vulval dermatoses. This review examined 54 patient records retrospectively at the University Hospital North Durham from 2016 to 2021 and prospectively from July to December 2022 referred for patch testing with vulval symptoms. Forty-eight patients were included with an average age of 51 years. Itch (48%) and discomfort or soreness (28%) were the main symptoms for which patients were referred. The most frequently requested patch test batteries after the British Standard Battery were medicaments, then cortico­st­eroid. The overall positivity of this cohort was 73%, in line with the available literature. The most common allergens were nickel, followed by fragrances. Of the patients with positive patch tests, 48% were relevant. Forty per cent had a partial response on withdrawal of the allergen, and 8% had complete response. Given the psychosocial impact of vulval pruritus and discomfort and the high positivity of patch testing in these patients, further population-based research is warranted to standardize patch testing in vulval dermatoses. Additionally, a low threshold for referral for patch testing should be considered to identify any element of allergic contact dermatitis in patients with recalcitrant vulval symptoms.

Role of Patch Testing in Chronic Spontaneous Urticaria.

BackgroundChronic spontaneous urticaria (CSU) is a common debilitating condition. Although not completely understood, the main pathomechanism involves autoimmune-related mast-cell degranulation. Patch test (PT) is the gold standard for the diagnosis of type IV cutaneous hypersensitivity. The relevance of PT to the diagnosis of CSU is debatable.ObjectiveWe aimed at determining the role of PT in selected patients with CSU.MethodsIn this retrospective study, we reviewed cases of patients referred for patch testing at our clinic. We compared results of patients with CSU (n = 134) and patients with suspected allergic contact dermatitis (n = 680; control group).ResultsAmong patients in the CSU group, 3% of patients had relevant reactions to PT, indicating that contact allergen avoidance resulted in resolution of all skin findings. Metals and textile dyes were the most relevant allergens. No significant differences were found between the groups with regard to the percentage of patients with positive PT and hapten reaction profiles. Patients from the CSU group were significantly older (4.1 years on average, P < 0.05), consisted of more females, and were less likely to have atopic trait (46% vs 58%, P<0.05).ConclusionIn some of patients, PT may assist in determining the cause of CSU.

The Role of Patch Testing with Indian Cosmetic Series in Patients with Facial Pigmented Contact Dermatitis in India.

Background:Pigmented contact dermatitis (PCD) is a non-eczematoid variant of contact dermatitis, mainly characterised by hyperpigmentation. It occurs due to contact with a low amount of allergen over a long duration of time. PCD is frequently seen in Indians but is often misdiagnosed or underdiagnosed because of the asymptomatic nature of the entity. The aetiology and the allergens implicated in PCD in the Indian subcontinent is still an enigma because of the limited studies done.Materials and Methods:This was an institution-based cross-sectional study, done at a tertiary hospital. Patch testing with Indian Cosmetic Series was conducted in a standardised method. Readings were taken at 48 hrs/72 hrs and on the 7th day [Figure 2a and b]. The International Contact Dermatitis Research Group (ICDRG) scoring system was used to grade the readings.Results:Out of the 38 biopsy proven cases of PCD, 18 (47%) showed lichenoid features, 17 (45%) showed spongiotic features, 3 (8%) showed a mixed lichenoid and spongiotic pattern. Among total 1216 (32 patches × 38 patients) patch applied, 42 (3.4%) showed positivity in 30 patients. Among allergen categories, colorant (PPD) was found to be most common (37%) followed by fragrances (18%), preservatives (15%), anti-microbial (11%) and emulsifier and anti-oxidants (each 8%).Conclusion:It is important to identify the allergens implicated in PCD to help in better management of the condition. Patch testing proves to be a non invasive, low cost method and its role is indispensable in identifying the correct allergen.

Clinical evaluation and role of patch testing in identifying the exogenous causes in patients presenting with hand eczema

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Hand eczema is a common dermatological problem resulting from both allergic and irritant contactants. Patch testing helps in both diagnosing and identifying allergens.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 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.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 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.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; 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.&lt;/p&gt;

Foot eczema and footwear dermatitis: Role of patch test using Indian standard series and footwear series

Context: Foot eczema is a common complaint encountered in dermatology outpatient department. Footwear dermatitis forms an important exogenous cause of foot eczema. Patch testing helps in identifying possible allergens causing footwear dermatitis. Aims: This study aims to study the clinical profile of foot eczema and to evaluate patch test results in these patients. Subjects and Method: Fifty patients with foot eczema were included in the study and underwent patch testing with Indian standard series and footwear series. Patch test results were read as per International Contact Dermatitis Research Group guidelines. Statistical Analysis Used: Descriptive data are given as mean standard deviation. Differences between patients were assessed by unpaired “t”-test and frequency of parameters by the Chi-square test. Linear regression analysis was used, and correlation coefficients were calculated by Pearson's method. P

Role of Patch Test in the Etiological Diagnosis of Chronic Urticaria

Role of Patch Test in the Etiological Diagnosis of Chronic Urticaria

Role of Patch Testing in Assessing Allergic Risk of Orthopedic Implants: Pre-and-Post Surgery

Role of Patch Testing in Assessing Allergic Risk of Orthopedic Implants: Pre-and-Post Surgery

The role of patch testing in the management of oral lichenoid reactions.

The distinction of oral lichenoid reactions from oral lichen planus may be difficult in a clinical setting. Our aims were to ascertain the utility of patch testing to confirm the association of oral lichenoid reactions with dental restorations and to identify the benefits of replacement of restorations, primarily made of amalgam. Patients seen in an oral medicine unit over a 10-year period diagnosed with oral lichenoid reactions, with oral lichen planus resistant to treatment or with atypical lichenoid features were included in this study. All had been subjected to skin patch testing. Histopathology reports blinded to patch test results were scrutinized. Patch-test-positive subjects were advised to have their restorations replaced. All were followed up to determine disease resolution for at least 3 months thereafter. Among 115 patients, 67.8% patients reacted positive to a dental material and nearly a quarter to mercury or amalgam. No correlation was found between pathology and skin patch testing results (P = 0.44). A total of 87 patients were followed up in clinic, and among 26 patch-test-positive patients who had their amalgam fillings replaced, moderate to complete resolution was noted in 81%. Skin patch testing is a valuable tool to confirm clinically suspected oral lichenoid reactions. Pathology diagnoses of oral lichenoid reactions did not correlate with patch test results. Prospective studies are needed to ascertain that a clinically suspected oral lichenoid reaction with a positive patch test result may resolve after the replacement of amalgam fillings.

The role of patch testing in non-immediate drug hypersensitivity reactions

Methods Herein we present case series of various non-immediate DHRs (occurring at any time as from 1 hour after the initial drug administration) amongst which drug-related intertriginous and flexural exanthema (Baboon syndrome), DRESS syndrome, fixed drug eruption and contact dermatitis. In all cases we performed patch testing with standardized and allergens prepared at our laboratory with the suspected drugs. The timing of patch test procedure was in median 6 weeks after the resolution of skin changes.

Allergy to Cosmetics

The term cosmetic has a broad definition and includes personal care products, hair care products, nail care products, and sunscreens. Modern cosmetics are safe for most users, and adverse reactions are very rare because the manufacturers invest heavily in safety, quality control, and product testing before releasing the product to the market. Despite these efforts, adverse reactions occur. Skin care products are major contributors to cosmetic allergic contact dermatitis (ACD), followed by hair care and nail care products. The most common allergens are fragrances and preservatives. The diagnosis of cosmetic allergy is established by reviewing the patient's clinical history and physical examination findings and confirmed with skin patch testing. Patch testing is the standard method for detecting allergens responsible for eliciting ACD. The purpose of this article was to review the prevalence, legislative laws, and role of patch testing in ACD.

The Role of Patch Testing in the Evaluation of Orthopedic Implant-Related Adverse Effects

In recent years, there has been a growing interest in the use of skin patch testing to evaluate patients for orthopedic, implant-related adverse effects. This may be done preoperatively to avoid implanting a material to which an individual may be allergic or postoperatively to implicate sensitivity as a cause for implant failure. There is emerging evidence that patch testing might have utility in the workup of implant-related adverse events; however, the level of evidence at the present time is weak and based only on a collection of case reports, series, and retrospective cohort studies (level IV evidence as per United States Department of Health and Human Services guidelines); there are no randomized controlled trials (level I evidence) with which to guide medical decision making. Recent reports have advocated that patch testing be broadly used in the preoperative evaluation of all patients self-reporting a history of metal sensitivity. In addition, several authors have advocated that patch test results should guide preoperative implant selection and postoperative implant removal. It is the opinion of this author that these recommendations are premature, lacking robust clinical evidence, and unfeasible given the broad-reaching logistical impact and societal costs involved. More robust clinical data are needed, and thorough cost-benefit analyses must be performed before such far-reaching and costly systematic practices should be broadly implemented.

Commentary on Crawford, et al, The Role of Patch Testing in the Evaluation of Orthopedic Implant-Related Adverse Effects

Commentary on Crawford, et al, The Role of Patch Testing in the Evaluation of Orthopedic Implant-Related Adverse Effects

The Role of Patch Testing in the Selection and Management of Metal Device Implants

The Role of Patch Testing in the Selection and Management of Metal Device Implants

The Role of Patch Testing in Oral Disease

The Role of Patch Testing in Oral Disease

Hand eczema-Clinical patterns and role of patch testing

Hand eczema-Clinical patterns and role of patch testing

Role of patch testing in antimicrobial drug eruptions.

Role of patch testing in antimicrobial drug eruptions.

Oral lichen planus and the burning mouth syndrome. Is there a role for patch testing?

There is controversy about the role of contact allergy in the pathogenesis of oral lichen planus (OLP) and the burning mouth syndrome (BMS). Patients with OLP or BMS might wish to pursue allergy testing in hopes of identifying the cause of their disease. Although patch testing in these conditions might provide useful information, one risks discovering allergens of uncertain relevance. We asked 2 experts in the field to discuss their approaches to evaluation and management of OLP and BMS, with an emphasis on the role of patch testing.

Acute generalized exanthematous pustulosis due to metronidazole: The role of patch testing

Acute generalized exanthematous pustulosis due to metronidazole: The role of patch testing

Acute generalized exanthematous pustulosis due to metronidazole: The role of patch testing

Acute generalized exanthematous pustulosis due to metronidazole: The role of patch testing